Surgery

Pre-surgical information for procedures

Your actions before surgery are just as important as the procedure itself in ensuring a healthy recovery. We provide you with a general as well as a procedure specific checklist to help you plan for the surgery well in advance.

 

General checklist before surgery

  • Confirm with your Medical Aid that the scheduled procedure has been authorized.¬† You should receive an authorization number as confirmation.
  • Visit the pre-admission desk at the hospital where the procedure is to be done to book a bed (this is not a bed reservation, but a confirmation for the hospital that you will undergo surgery on a specific date).
  • Take note of the SMS from our Office the day before your surgery. This SMS confirms the time of surgery, your admission time and the time of last food intake.You should still take your chronic medication the morning of the surgery, but with a sip of water.
  • All blood thinning agents should be stopped before surgery. Do not take any aspirin seven days before surgery unless advised otherwise.
  • If you are on Warfarin/ Plavix treatment, please enquire from our Office the correct use before surgery.
  • Plan ahead for transportation to and from the hospital.
  • Make sure at which hospital the procedure will be done. Dr Jonker’s Tuesday list is performed at Mediclinic Potchefstroom and the Wednesday list at Mooimed Private Hospital.
  • You may want to adjust your wardrobe according to the surgery. If you have shoulder surgery a blouse/shirt with front closure or sweater are easy to wear post surgery. If you have knee surgery, a short or tracksuit pants will be comfortable.
  • One week prior to the procedure use Hibi-scrub during each bath/shower and apply the prescribed nasal spray daily (only relevant to replacement surgery).
  • The first follow up is about two weeks after surgery, preferably scheduled for a Wednesday. The purpose of the follow-up consultation is to check the wound and remove stitches. You can arrange with your family doctor (GP) to do this if you live far away.

Specific checklist

Unicompartmental knee replacement

  • Take note of the general checklist.
  • Make sure you have received any equipment you will need as aid when you get home from the hospital. This may include crutches, ice packs or coolers. Dr Jonker will provide you with the relevant prescription.
  • Understand the potential risks and benefits of the surgery, and ask Dr Jonker or staff at our Office any questions that will help you better understand the procedure. It can also help to talk to someone else who had the same surgery.
  • Practice walking with your crutches in case you need to use them after surgery.

Patient Specific (MyKnee) total knee replacement

  • Take note of the general checklist.
  • It is important to undergo the scan of your knee three weeks in advance of the procedure date, as the prosthesis is manufactured in Switzerland.
  • Make an appointment to consult a physician three weeks prior to the procedure date.

Shoulder replacement surgery

  • Arrange your living area for the comfortable reach of items that you will use regularly (telephone, radio, TV remote, bathing items, plates and drinking glasses, medications).
  • Take action and move items to limit the risk of falling, for example pick up any throw rugs or other objects that could cause you to trip and fall.
  • Prepare and freeze a few weeks worth of meals that can be easily re-heated.

 

Day of surgery

General information
Arrive at the hospital on the date and time as confirmed through our SMS system the day before surgery.

What to expect while in hospital

  • Dr Jonker does ward rounds from 07h00 in the mornings.
  • After surgery he will discuss the outcome of the surgery with you.
  • The wound will be inspected, cleaned and dressed.
  • Hospital staff is to assist you with scheduling your 14-day follow-up appointment.
  • Upon discharge you should request a prescription for pain medication, sick note and X-rays.
  • Do not open the wound unless it is absolutely necessary. The wound should remain dressed and not get wet for two weeks.
  • Physiotherapist will start the rehabilitation process directly after surgery or the following morning and you will be discharged with a home treatment plan.

Knee replacement surgery (Unicompartmental and total replacements)

  • After surgery you will go to ICU/High Care where nursing staff can regularly monitor your recovery.
  • You will be given a prescription for pain medication and schedule a series of follow-up visits sometime around one week, one month, and three months after surgery.
  • The incision usually starts to close within six days. Physicians may fit you with a brace that allows a limited range of movement.
  • You may be able to bear weight on your knee when discharged from the hospital. Depending on your progress and type of surgery, crutches are normally prescribed from two weeks (unicompartmental) up to six weeks (total knee replacements) post surgery.
  • Your physician and physical therapist will help you learn to balance on the new knee. You will practice unaided walking and going up and down stairs before you leave the hospital.
  • The duration of stay in hospital may vary from three to five days depending on each individual’s progress.
  • The physician will be responsible for your discharge and prescription of your chronic as well as blood thinning medication to prevent blood clots.
  • Post operative anti-thrombosis stockings are prescribed in all cases and should be worn for two weeks after surgery.

Shoulder procedures:

  • As a result of the nerve block during surgery, your shoulder and arm may feel completely numb immediately after the operation. This could last for a few hours.

Post-surgical information

Two week follow-up consultation

  • During this consultation, the nursing sister will remove stitches and do wound care.
  • If any problems or abnormalities are observed, the nursing sister will inform Dr Jonker. You may be requested to wait for Dr Jonker, as he is in theatre on Wednesdays and not immediately available to examine the observed problem.
  • Remember to also schedule the two month follow-up appointment at our Office during this appointment.

Replacement surgery

  • Most people are able to return to normal everyday activities such as dressing themselves within the first two weeks after successful shoulder replacement surgery. Your physician will let you know when it is safe to drive and perform other tasks.
  • Total recovery time ranges from three to six months, and physiotherapy is required to gain range of motion with the new joint.
  • Wear the sling every night for at least the first month.
  • Initially, push yourself up in bed or from a chair using your non-operated arm.
  • Do the home exercises but not more than prescribed, as overuse of the shoulder can be harmful.
  • No sports or heavy lifting should be performed for at least six weeks.
  • Arrange for support at home when living on your own.
  • Leave the dressing on for three days. The steri-strips will slowly peel off in time by themselves.

Instability surgery

  • For the first three weeks your sling must be worn in bed. We recommend that you lie on your back or on the side which was not operated on. You can use ordinary pillows for comfort and support. If you are lying on your side, one pillow slightly folded under your neck gives enough support. A pillow folded in half supports the arm in front and a pillow tucked along your back helps to prevent you rolling onto the operated shoulder during the night.
  • For the first three weeks most activities of daily living for example cooking and dressing must be carried out using your un-operated arm.
  • Dr Jonker together with your physiotherapist will advise you when it is safe to resume your sport and¬†leisure activities. This will vary according to your sport and level, as well as the period required to retrain your shoulder muscles with physiotherapy.
  • You will not be able to drive for a minimum of six weeks.
  • Returning to work will depend on the size of your tear and your occupation. Dr Jonker will discuss this with you during consultation.

Follow the guidelines and prescriptions for the use of the sling for your quick and correct recovery