Knee replacement surgery

[seemster]

Hi, does anyone have any insights re: best hospital in London for knee replacement surgery?

My dad is 77 and about to get a referral. He was asked if he has a preference on hospital - he'd like something close, (Charing cross, ealing, hammersmith hospitals are closest to him geographically) but he also wants to know which hospital might offer better quality surgery and after-care in the event of any problems etc.

Also interested in any other thoughts / experiences / advice to share re: knee replacement surgery

Many thanks

[TheCat]

The knee unit at the Wellington hospital. Consultant I've had there is David sweetnam. Have referred him to others who have needed knee surgery, and all reports (including my own) are top notch.

[seemster]

Hi, thanks for that - unfortunately we're not going private so restricted to NHS hospitals. Even though they are good about letting you choose where to go it does seem quite hard to find ways to compare your options. Anyway, thanks for the input, we are going with Charing Cross.

We've been advised to check that we'll get the necessary home-help and after care as mum won't be able to manage. Any other advice / input from people who've had or whose relatives have had knee surgery also welcome!

[Dee Woffaz]

I had a full knee reconstruction, ACL & Popliteus tendon replaced at the Chelsea & Westminster i couldn't fault them. THe Dulwich Medical Centre who were supposed to be supplying after care however denied having me registered as a patient. I dont think we need to start any more threads on how appalling the DMC are though.

Good luck and i hope you have a speedy recovery.

[cathy p j]

Hi, I have recent experience of knee surgery. I would say the most important advice is to check what support your father will be offered both before and after the surgery. I have had knee replacement operations on both knees carried out at Lewisham Hospital in the past couple of years, and their "before" and "after" care was fantastic!

Before the surgery, I was visited at home by an occupational therapist from the hospital. She went round the whole house, checking how I would manage when discharged, and what practical help I would benefit from. She arranged delivery before my admission of equipment such as raised toilet seat, chair raisers for my armchair, bath seat (as we don't have a walk-in shower), commode for the bedroom (as we have many steps between bedroom and the only toilet), a "perching stool" for the kitchen to enable me to sit/lean and free both hands from my crutches to make a drink or sandwich etc, and they also fixed a grab handle to enable me to get down the steep step into my kitchen. She offered additional things including a bed raiser, and an extra commode for downstairs, which I didn't feel I needed at the time.

The "after care" was really excellent. Lewisham Hospital provide a specialist community-based team that support patients who have undergone knee or hip replacement surgery once they come home. They have specialist orthopaedic nurses, physiotherapists and support workers. They visited me in hospital to introduce themselves, and started visiting me at home on the morning after my discharge, and came almost daily for some time, infact as long as you want them to. A big bonus was that the nurse practitioner was able to prescribe medication, so I didn't even have to get my GP to prescribe strong painkillers once those supplied by the hospital had run out! A second big bonus was that physiotherapy was provided at home, so I didn't need to go to the hospital for physiotherapy appointments! It was also great to be able to phone them with any small queries, and know that they were there to support you.

I'm not sure what you mean by home help, I didn't need any help with household things as my husband was able to manage, so I am not sure how easy it would be to get social services to help out?

I hope that is helpful and I hope your father's operation goes well.

Cathy

[Pugwash]

Most hospitals and Social Services provide either or both a Reablement Service or Intermediate Care which is free of charge for up to 6 weeks.

Intermediate Care (ICT) is staffed by OTs and Physios with a specially trained team of Rehab Support Workers. The hospital OTs/Physios send in goals for each patient to achieve within the 6 week period. It could be exercises to strengthen muscles, working from walking with crutches to walking stick etc. RSWs will work with people in their own homes at least once a day (usually more) on exercises devised by therapists

Reablement Teams have RSWs and usually an OT - they work mainly on building up confidences post operation, getting people back to being independent with their personal care and activities of daily living. Sometimes you get a mixture of Reablement and ICT RSWs.

[seemster]

Thanks everyone, this is really helpful stuff, much appreciated.

Cathy, the hone help I referred to is partly the knee-related after care but also more basic things like getting him to the bathroom - I guess the kind of nursing care that will be available in hospital but not home. But maybe he will be more mobile than we're imagining...

[JDR]

Hi

I am a physio dealing with patients exactly like your father. Normally the hospital will only discharge someone to their own home once they are safe. In most cases walking with aids (crutches or Zimmer frame most common) and make sure that they know how to do stairs safely prior to discharge.

Practically patients need to prepare for surgery. Make sure bills are paid, heavy shopping bought in advance, fill the freezer up with meals that can be reheated etc. Also, have ice packs ready, though frozen peas are fine too. The first couple of weeks at home aren't easy but if your mum is there and can do basic jobs such as cooking then he'll probably be fine.

Good luck

[seemster]

Thanks again, much appreciated...