Once you’ve decided to go ahead with the operation, your name will be put on a waiting list and the hospital will contact you, usually in the next 6–8 weeks.
Most hospitals invite you to a pre-admission clinic, usually about 2–3 weeks before the surgery. You’ll be examined to make sure you’re generally well enough for the anaesthetic and the operation. This may involve the following tests:
- blood tests to check for anaemia and to make sure your kidneys are working properly
- x-rays of your hip
- a urine sample to rule out infection
- an electrocardiogram (ECG) tracing to make sure your heart is healthy.
The hospital team will probably tell you at this stage whether the operation will go ahead as planned.
It’s also advisable to have a dental check-up and get any problems dealt with well before your operation. There’s a risk of infection if bacteria from dental problems get into your bloodstream.
You should discuss with your surgeon, anaesthetist or nurse at this pre-admission clinic whether you should stop taking any of your medications or alter the doses before you have surgery. Different units and different surgeons may have differing opinions on this.
At this visit you may also see an occupational therapist to discuss how you’ll manage at home in the weeks after your operation. They’ll also advise you on aids and appliances that might help. You can also ask about these when you go for your pre-op assessment.
Going into hospital
You’ll probably be admitted to hospital early on the day of surgery, but it may be earlier if you haven’t attended a pre-admission clinic or if you have another medical condition that needs to be treated before you have the operation.
You’ll be asked to sign a consent form giving your surgeon permission to carry out the treatment. You may also be asked if you’re willing for details of your operation to be entered into the National Joint Registry (NJR) database. The NJR collects data on hip and knee replacements in order to monitor the performance of joint implants.
Just before your operation you’ll be taken (usually in your bed, but you may be walked) from the admission ward to the operating theatre. If you're feeling worried, you may be given a sedative medication (a pre-med) while waiting in the admission ward, which will make you feel a little drowsy. You’ll then be given an anaesthetic. This may be either an epidural or a spinal anaesthetic, or alternatively a general anaesthetic.
An epidural will only affect the lower half of your body, and a spinal anaesthetic will only stop you feeling pain in the affected area. This means you'll be awake during the operation, but you may also be sedated, if necessary, to keep you relaxed during the course of the operation. A general anaesthetic will affect your whole body and will probably make you lose consciousness.