Frequently
Asked Questions – Knee Replacement Surgery
Do
I need a referral from my doctor?
No a doctors referral
is not necessary we carry out a full clinical
examination x-rays are taken as well as blood
and urine tests and a consultation with the
orthopaedic consultant the day before surgery.
Would
it help if I brought my MRI's, X-Rays, etc
with me?
If you can obtain them they may be
useful but we undertake our own investigations
and x-rays so it is not necessary to bring
them. Any MRI's you may wish to bring should
be less than 3 months old.
Should
I inform the doctor if there is anything unusual
in my medical history?
Yes although this is covered in the pre-surgery
enquiry form, which the doctor will have read
it is always helpful to mention any major
points again. To download the pre-surgery
questionnaire, go to our Download
Page.
Will
I have the opportunity to ask questions?
Yes
of course, you will find that the surgeon
is quite open to questions and will explain
everything in detail.
Can
my partner attend the consultation?
Yes that they are welcome to attend;
the surgeon is quite open and has nothing
to hide.
Can
I bring a relative or friend?
Yes there is an in house modern bed
& breakfast facility especially for friends
& family members.
Can
you tell me more about your facility in Belgium?
Our partner Hospital in Torhout, Belgium
was established in 1948 it has 197 beds is
equipped with the latest technology and carries
out surgical procedures with confidence offering
the very best medical care and attention.
The
hospital staff comprises of 40 physicians
and over 420 employees. Each physician is
a specialist trained in one of the primary
medical disciplines: anaesthesiology, general
surgery, vascular surgery, ear nose &
throat, gynaecology & obstetrics, oral
& facial surgery, orthopaedics, urology,
dermatology, internal medicine, cardiology,
gastroenterology, pulmonology, rheumatology,
radiology. The five operating theatres are
equipped with the newest technology. The emergency
department and the 8-bed intensive care facility
are staffed 24 hours a day with on site resident
cover.
Nursing
staff are dedicated to providing a quality
service and effective patient care at all
times giving their full commitment and excellence
in caring for their guests. In addition the
hospital is equipped with an extensive physical
rehabilitation unit, a state-of-the-art laboratory
and radiology department are available on
site. The hospital places a strong emphasis
on cleanliness and the quality of its food.
All meals are prepared on site and the menu
changes daily.
There
is a laundry service, a hairdresser and even
a massage available for friends and family
staying there.
On
which days is the surgery undertaken?
Surgery is performed either on a Tuesday
or Thursday. The day before surgery is set-aside
for patients clinical and pre surgical examinations
and tests.
How
many main orthopaedic procedures are done
at the Hospital per year?
The two consultant
surgeons Dr Dauwe and De Ghent have been operating
at this hospital since 1992 and carry out
carry out 400 major procedures per year approximately
200 hips, 120 knees & 80 spine procedures.
In Belgium consultants use the title Dr.
How
many people does your organisation treat a
year?
Approx 250 hip,
knee and back surgery ... the split is approx
40/40/20 we have been functioning for 18 months.
Will
I need a blood transfusion?
Generally for hip surgery it is less likely
that blood will be needed for knee surgery
it is quite possible.
If
need is this included in price?
Transfusion is included in the price.
What
is the blood screening policy?
European policy
on filtration and testing of blood is very
strict. The hospital is equipped with its
own accredited laboratories. Blood samples
can be screened day or night.
The
ICU can locally provide blood-gas analysis
and ionogram under the supervision of the
central laboratory, which is responsible for
quality.
Blood transfusion services are organised as
specified in the European guide to "qualification
assurance of blood donation and preparation
use" (edition 8th January 2002 under
code R 9515)
Practical
arrangements describe:
Indications
Method
of transfusion
ABO
and rhesus control
Blood units are supplied by the Blood Transfusion
Centre, which is regulated by the Belgian
Law dated 5th July 1994, pertaining to blood
and derivates of blood of human origin in
addition the European guide to "qualification
assurance of blood donation and preparation
use" is strictly followed (edition of
8th January 2002 under code R 9515)
Articles 8 & 4 of the Belgian law state
that blood must be screened for hepatitis
B and C, HIV, syphilis and anti HBc antibodies.
What
steps are taken to prevent blood clots (thrombosis)
The hospital will administer a low weight
heparin 'B' to prevent thrombosis. You may
also receive some of these drugs to take home
with you.
Is
there much Pain with Knee Replacement Surgery?
Proper pain management is important
in your early recovery. Although pain after
surgery is quite variable and not entirely
predictable, it can be controlled with medication.
Initially, you will probably receive pain
control medication through an intravenous
(IV) connection so that you can regulate the
amount of medication you need. Remember that
it is easier to prevent pain than to control
it. You don't have to worry about becoming
dependent on the medication; after a day or
two, injections or pills will replace the
IV.
I
wish to fly shortly after my surgery is this
safe?
Yes this is quite safe and as you are
receiving low weight heparin 'B' to prevent
thrombosis there should be less risk of thrombosis
than usual.
What
type of anaesthesia is used?
Where possible patients receive epidural
anaesthesia, the anaesthetist will discuss
the type of anaesthesia used prior to surgery
if you have a preference please state this
to the anaesthetists or surgeon.
If this method is appropriate for you, you
will first be sedated through the IV in the
pre-op area. This relaxes you and minimizes
the discomfort of the initial epidural procedure.
With epidural anaesthesia, a narrow catheter
is placed between two bones of your spine.
A controlled flow of anaesthetic goes through
the narrow catheter, anaesthetising your body
from the abdomen down so you will not feel
anything during surgery.
If you are undergoing general anaesthesia,
you will first be put to sleep by IV medication.
A mask or a breathing tube then gives an anaesthetic
gas with is monitored by the anaesthetist.
Could
you tell me a little more about the anaesthesiologist?
There are 5 anaesthetists
in the department. The head of Anaesthesia
is Dr Haesaert also there is; Dr Billiet,
Dr Alliet, Dr Goudy, and Dr Marrécau.
Could
you tell me a little more about the intensive
care facilities?
The hospital has
a fully functioning 24 - hour accident &
emergency department, paramedics, and fully
equipped intensive care unit. Response time
for a doctor to be at bedside day or night
is under 2 minutes.
How
long will I stay in Intensive care?
Usually less than 1 day however if you have
any history of heart problems are overweight
or have other risk factors we may keep you
in intensive care for a longer period, this
is a perfectly normal procedure.
Is
there any additional cost associated with
this?
Providing the length of stay in intensive
care is just a couple of days there is no
additional cost.
What
make of prosthesis is used?
We prefer to fit
Zimmer orthopaedics prosthesis - www.zimmer.com
Zimmer is the largest and most experienced
manufacturer of prosthesis and its advanced
technical capacity means that it produces
some of the best and most durable prosthesis
on the market today. We try to always fit
not only the best product available but also
one that has been tried and tested for a number
of years.
What
is the expected life of this implant and it's
track record?
These prosthesis
are very durable and should last 20 to 30
years.
I
understand that there is cemented as well
as cement-less fixation, which is the surgeon
likely to use?
In hip and knee replacement we always try
to work with cement-less unless the indications
are for cemented i.e. the bone structure is
week etc.
The
reason for not using cement is that the tough
alloy used in the construction of the prosthesis
is both porous and rough (on the outside)
where it meets the bone, this enables the
bone to grow and fix itself to the prosthesis
(like the barnacles on the hull of a ship).
After a short while the bone grows over the
prosthesis and the two become firmly fixed
together. With cement there is always a possibility
of the cement breaking down or working loose.
Is
there a Brochure I can look at?
The orthopaedics prosthesis brochures can
be downloaded here.
Is
the Continuous Passive Motion machine used
to exercise after knee surgery?
YES in addition to the morning physiotherapy
sessions in the afternoon you may be placed
on a CPM machine.
What
charges are not included?
Phone calls, accommodation for friends or
family
It
would be nice to speak to some one who has
experienced using your services, could you
please provide a reference that I could reach
by telephone?
Yes we have many please contact us at the
office and we will provide some details.
I
am not very mobile can you assist with wheelchairs?
Yes we can arrange for you to be taken by
wheelchair through the airport if you choose
to fly and wheelchair assistance on Eurostar
if needed. We would recommend wheelchair assistance
if you have any mobility problems. Please
ensure that we are informed at the office
so that we can best assist you.
How
long is the duration of stay?
Durations of stay are as follows
Hip Resurfacing - 11
days Hip Replacement - 11
days
Knee Replacement - 13
days
Hip or Knee Revisions
- 16 days
Can
I stay longer if required?
Yes, there is an
additional 7 days stay available. We recommend
the addition period of stay for women over
75 and men over 80 or if there are any mobility
problems. The extra week includes full physiotherapy
and enables the patient to recover more fully
before returning home.
How
do I book?
Just call us and
let us know that you wish to proceed, together
with you we set a target date then you confirm
your travel arrangements with us. We then
dispatch a confirmation letter, and a manual
explaining the surgery. The manual can also
be downloaded from our Download
Page.
Methods
of Payment
Credit & Debit Card
Credit
& Debit Card in Euro's or GBP - Maestro, Switch, Solo, Visa,
Mastercard, Delta, Electron (add 3.5% surcharge)
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Frequently
Asked Questions – Knee Replacement Surgery
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