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Preparation for Orthopaedic Surgery

On this page, you will find information on how to prepare for your Orthopaedic Surgery

Before Your Surgery

Fasting Instructions

Fasting is essential prior to surgery. In the event you did not follow the instructions, the surgery will be rescheduled. No food or drinks (except plain water) after midnight or as instructed. Last drink allowed is half a cup (100ml) of plain water.

Medicine

Certain medications need to be stopped in preparation for the surgery. Please inform your doctor of all medications you are on, especially blood thinners or herbal medications.

Special Instructions

  • Any recent infection, be it involving the throat, lung, urinary tract or skin must be highlighted to the surgeon prior to surgery. Your surgery might have to be postponed.
  • Have a parent / legal guardian to give consent if you are below 21 years old.

Pre-Operative Assessment

Financial counselling for estimated bill for hospital stay and surgery will be discussed.

You would be asked to come to the Pre operation assessment at least 2 weeks before scheduled surgery date to do tests that determine your fitness for the surgery. Examples include:

  • Blood tests
  • Urine tests (if indicated)
  • MRSA screening
  • Chest Radiograph
  • Electrocardiogram

You can request to speak to our patient educator at Preadmission clinic if you have any queries.

You would be instructed to go to the Orthopedic Diagnostic Centre for assessment if required.

Smoking

Smoking causes breathing problems and impedes the rate of healing. Try to decrease smoking or seek help to stop smoking.

One day before Surgery

The nurse from Same Day Admission (SDA) Clinic will contact you one working day before your scheduled surgery date. The nurse will inform you on the following:

  • Time to report to hospital and time of surgery. Please bring along your admission kit.
  • Instruction to fast before surgery.
  • Medications to consume before surgery.
  • Bring all CD / X-rays or any medical notes from doctors on the day of admission and hand them to the nurse.
  • Safekeeping of personal items and valuables in the hospital. Do not bring valuables to hospital.

Pre-operative Bath and Shampoo for Elective Surgical Patient:

Antiseptic wash eg: Chlorhexidine Gluconate 4% or Octenisan

Bath and Shampoo

Day of Surgery

Please remove all make up, nail polish and jewellery. You are advised to bring your dentures, spectacles or hearing aids if any. You would be given a gown to change to before going to the operating theatre. Please arrange someone to accompany you home when you are discharged.

After the Surgery

After your surgery, you will be brought to the recovery room in the operating theatre to be monitor before returning to the ward. In the recovery room, the nurse will frequently monitor your vital signs (blood pressure, heart rate, respiration rate, temperature and pain level).

Your loved ones are advised to wait at the waiting area. Please be informed that the recovery time varies and may take up to several hours. You may be transferred to

  • the general ward/high dependency unit / intensive care unit depending on your condition.

Care after Orthopaedic Surgery

The aim of care after your surgery is to allow you to return to your daily activities. The team will advise you regarding the daily activities and the physiotherapy sessions.

Orthopaedic Team

You are cared by a multidisciplinary team comprising of the Surgeon / Doctors / Advanced Practice Nurses/ Resident Nurses/ Nurses/ Physiotherapist/ Occupational Therapist / Medical Social Worker / Dietician.

Activity

The nurses and physiotherapists will assist / advice you on your daily activities. The therapists will teach you on the specific exercises. You can increase the activity daily to enhance your strength. Your rehabilitation program will continue after you go home.

During your hospital stay, inform the nurses if you need assistance to go to the toilet take a shower or cannot reach your personal belongings.

Breathing

There may be an oxygen tube in your nose which would be removed when you are feeling better. You will do deep breathing and coughing exercises. You may be given a breathing device to expand your lungs and help get oxygen to your lungs.

breathing

Circulation

It is important to perform leg exercises to help your blood flow. You may be given a pair of anti-embolic stockings and sleeves (pneumatic pumps) wrapped around your legs to prevent deep vein thrombosis.

circulation

Pain Management

You will have pain after surgery. The degree of pain you may have will vary and differ for individual. Your nurse will ask you to rate your pain on a scale. The goal is to minimize the pain so that you can rest and exercise. Pain medicine can be given in different ways. You will be prescribed with oral medication to manage your pain and keep you comfortable.

You may receive analgesia through an intravenous (IV) access into your blood vessel (vein). This can be infused to you by either a continuous pump or a Patient Controlled Analgesia pump (PCA). You may also receive your analgesia via intramuscular (IM) injection.

​Patient Controlled Analgesia pump (PCA)

Intravenous infusion of analgesia (Continuous pump)


In addition, you may also receive an injection around the nerve in your upper thigh (femoral nerve block) or a spinal epidural block. It will be done by the surgical team to manage your pain. Only take the medications served by the nurses.

Food/Fluids

You will have fluids through intravenous at first. It will be stopped when you are eating and drinking well. Increasing food slowly may help to avoid nausea that can happen after anesthesia or with use of pain medicine.

Bladder /Bowel care

You may have a tube (catheter) to pass urine from your bladder. This catheter will be removed once you are ambulating. Anesthesia and pain medication can cause constipation .Drink plenty of fluids and eat vegetables and fruits. A stool softener or laxative can help normal bowel function. Inform your doctor/ nurse if you are unable to open your bowels.

Exercises

The physiotherapist will assess and teach on the exercises to promote good recovery. The physiotherapist will advise on the ambulation status and any need for walking devices. You will continue with your exercises until after discharge.

Wound Care

Your incision may be closed by adhesive stitches, surgical tape, or staples. The wound should be covered with adhesive bandages otherwise explained by your doctor or nurse. You may also have a temporary tube (a drain) coming out of the incision. Your surgeon will decide when to remove the drain. Upon discharge, the ward nurse will provide information to you on managing your wound.

Ice Therapy

You may be given ice pack to relieve swelling and pain. Different modalities will be used.

Discharge plans

You are encouraged to discuss with your family and identify a caregiver that will care for you after discharge. The caregiver can receive training from the healthcare team in caring for you after discharge. You may also explore the options of transferring to a step down facility (Community hospitals) for rehabilitation if there is no available caregiver. Please inform your Staff Nurse-in-charge of your choice of step down facility. You may approach the nurse to find out about the list of community hospitals available.

On the Day of Discharge

You will be given a Patient Education Information pamphlet on how to care for yourself at home. You may receive an implant card if you had metallic implant inserted during your surgery.