FAQ

Questions

Answers

1. Q: What are your office hours?A: Our office hours are from 9.00am-5.00pm Monday to Friday (excluding public holidays).
2. Q: Where are your offices located?A: Appointments are available at 2 Central Coast locations, Kanwal and Erina.

Kanwal
Suite C4, Kanwal Medical Complex
654 Pacific Hwy
Kanwal, NSW, 2259

Erina
Ground Floor Shop COM2
North South Drive (off Karalta Rd)
Erina, NSW, 2250

For ALL Appointments – please phone (02) 4393 3820.
3. Q: Can X-rays be performed at your offices?A: At Kanwal, Xray facilities are available in the same complex. At Erina, Xray facilities are available in close proximity.
4. Q: What do I need to bring with me to my appointment?A: Please bring the following items with you:

  • Referral letter from your General Practitioner or referring doctor;
  • Details of previous orthopaedic surgery;
  • Medicare card and/or Veteran Affairs card;
  • Private health insurance details;
  • Any relevant investigative tests, even if the results have been reported as normal.  These may include X-Rays, MRI’s, Bone scans, ultrasounds, nerve conductions studies and so on;
  • A list of any medications you are taking;
  • A list of any allergies you have, particularly with respect to drugs or medication;
  • Physiotherapy progress reports, if you have been receiving treatment to the problem area;
  • If you are claiming Worker’s Compensation, please bring details of the insurance company involved, the name and phone number of your contact person, and also your claim number;
  • Payment for the consultation.
5. Q: What are the costs of surgery?A: For patients with Private health insurance, the fees set are determined by the complexity of the procedure, the amount of preparation and expertise required.

As there are many different health funds with many different levels of coverage, giving an exact quote on this website is not possible. Our staff will give every patient an item number quote for each procedure. We will also make contact details of our Anaesthetists and Surgical Assistants available to you to assist in establishing costs of their services.

For patients without Private health insurance, it is still possible to have your procedure performed at Berkeley Vale Private Hospital or Gosford Private Hospital. The costs for the operating theatre, prosthesis, hospital stay, ancillary services and doctors fees are payable by you, with the Medicare rebate applicable for doctors fees only.

Quotes will be provided for patients who wish to pursue this option. A total ball park cost for a primary hip or knee replacement is between 20,000-25,000 dollars
6. Q: What is osteoarthritis?A: Osteoarthritis is the most common type of arthritis. Arthritis means inflammation of a joint, while osteoarthritis refers to damage to the surface of the joint or the cushion known as cartilage. In severe cases, the cartilage is damaged down to the level of bone. The body’s response to this is for the joint to become inflamed. People feel this as pain, swelling, warmth and restriction of movement or stiffness resulting in interference with basic activities like walking.

For more information, click here.
7. Q: What is the difference between a joint reconstruction and a joint replacement?A: A joint replacement is one type of joint reconstruction that involves the removal of at least a part of the joint (bone and articular cartilage) and replacing it with artificial material.

All other joint reconstructions can take many forms, but in each the patient keeps their original, native joint.
8. Q: What is the difference between a Primary and Revision joint replacement?A: Primary refers to the first time a particular joint is replaced. 

Revision refers to subsequent surgery to the same joint that involves removal of part or all of the previous artificial joint and insertion of new joint components. As such, this can mean more extensive surgery. Revision joint replacement can be necessary for a number of reasons including infection, loosening and instability.

Despite this, the good news is that 90% of primary joint replacements are still successfully remaining in patients at 20 years after surgery. This is much better than we ever imagined they would a generation or two ago.
9. Q: Should I wait for new treatments rather than having a joint replacement?A: Once you have decided that your quality of life is sufficiently reduced and you have been assessed and advised that joint replacement is a suitable treatment, I would strongly advise against delaying surgery on the basis of future potential treatment. There may be other reasons to delay surgery, however awaiting future therapies may mean years, or even decades of trials before the treatments are deemed safe for general use. This may mean that you experience years of unnecessary suffering in the meantime.

Remember, the survival rate of primary joint replacement is 90% at 20 years after surgery.
10. Q: What are the risks of primary joint replacement?A: Any elective (non-emergency) surgical procedure is associated with a small level of risk. The potential benefits of the surgery must greatly outweigh the potential risks. In other words, the risk of being worse off if you don’t have surgery has to approach 100%, and there has to be virtually no chance of regaining your quality of life without having the surgery.

The risks can be thought of as being similar to the risks taken when crossing the road, driving a car or being a passenger on a plane. Precautions are taken to minimize the risk of complications or mishaps, but undesired outcomes may still occur despite this. The risk of being worse after primary joint replacement surgery is between 2-3%.

Specific risks related to hip replacement and knee replacement will be discussed further in those sections.
11. Q: What are my options for the anaesthetic?A: There are several options for your anaesthetic. These include general anesthesia, spinal (regional) anaesthesia, and peripheral nerve blocks. These are commonly used in various combinations that also links into the pain relief needed after the operation.

Information regarding the options will be given to you as well as suggesting that you speak to your Anaesthetist to discuss your preferences and the options prior to your surgery.

If this is not possible, your Anaesthetist will assess you shortly after admission to hospital on the day of your surgery.
12. Q: Will it be painful after surgery?A: As a general rule, hip replacement surgery is not as painful in the first few weeks after surgery compared to knee replacement surgery, especially if both knees are replaced at the same time.

Pain relief is especially important in the first few days after surgery as we start getting you mobile. Various types or modes of pain relief are utilised during this time including intra-articular local anaesthetic infiltration, nerve blocks, oral and intravenous agents and cold therapy. The aim is to minimize the use of strong narcotics that can be associated with prolonged nausea, constipation and sedation.

After the first few days, oral medications should be sufficient to manage discomfort. The pain you experienced prior to surgery should diminish rapidly; remember that this would have been permanent without having had the surgery. The pain felt after surgery is temporary, and should further diminish over the next few weeks.
13. Q: Will I need walking aids after surgery?A: Following Primary joint replacement, the aim will be to fully weight bear as soon as possible. This will necessitate the use of walking aids with a physiotherapist, and to progress to one stick by the time of discharge, when stairs will have been negotiated confidently and comfortably. Crutches are rarely necessary.

As Revision joint replacement can be more complex, it may be necessary to use crutches for at least 6 weeks. Dr. Hasn will usually be able to advise on this likelihood prior to surgery.
14. Q: How long does it take to recover from primary joint replacement surgery?A: Recovery is seen differently by everybody, depending on their personal circumstances. However, as a general rule, recovery takes an average of 3 months, being somewhat quicker after hip replacement compared to after knee replacement.

Some general guidelines:

  • Driving; 4-6 weeks
  • Sleeping comfortably; at least 2-3 months on average
  • Walking and Shopping; without limitation
  • Climbing Stairs; by time of hospital discharge
  • Sports and Recreations such as golf, bowls, mowing lawns, dancing; usually 6-8 weeks but sooner if confident.
  • Tennis, skiing, surfing, boating, gardening, swimming, cycling etc. These are best discussed with Dr Hasn.
You should continue to notice gradual improvements in comfort and mobility for at least 2 years, although not at the same rapid rate as you experienced the first 3 months after surgery.
15. Q: Will there be much swelling after surgery?A: Everyone develops swelling after joint replacement surgery. The swelling not only affects the operated part but also the leg below. This may last several months until complete resolution and is part of the recovery process.

Occasionally, swelling is associated with a post-operative problem, but there are usually other signs associated with this.
16. Q: Will I be OK going through security screening, such as at the airport?A: Your replacement will have metal components and thus may trigger metal detector alarms. We will make laminated cards available identifying you as a joint replacement recipient. 
17. Q: What limitations are there on my new joint? What can or can’t I do?A: The main limitation is to minimise impact activities such as running, jumping and contact sports. The implants were designed to help regular activities of daily living such as walking, climbing stairs, shopping, swimming and cycling. As the implants have proved to be lasting longer than they were originally expected to, people naturally have been keen to “explore the boundaries.” Always seek advice if in doubt.

With specific reference to knee replacements, most people find kneeling somewhat uncomfortable after surgery, and thus tend to avoid doing it.
18. Q: What follow-up is needed after joint replacement?A: Following discharge from hospital, follow-up will occur 1 or 2 times in our offices in the first 3 months. At that stage, arrangements will be explained for subsequent follow-up at one year after surgery with new  X-Rays.

If all remains well at that time, the next follow-up is at 10 years after surgery with new x-rays to compare with those done at the one year follow-up. Of course, if any issues arise in the interim, seek advice sooner rather than waiting until one or 10 years.

The most important thing you can do to look after your joint replacement is continue follow-up with an orthopaedic surgeon. By the time symptoms of a problem with your replacement have arisen, the possibility of a simple solution decreases substantially. This may mean more extensive revision surgery is required than would otherwise have been needed.
19. Q: What is the difference between hip replacement and hip resurfacing?A: Hip replacement involves removal of the whole femoral head (the “ball”) from the femur, and the arthritic portion of the acetabulum (the “socket”) and then replacing it with artificial material.

Hip resurfacing involves removing only the arthritic part of the femoral head, and the arthritic portion of the acetabulum before replacing it with artificial material.
20. Q: How will my new hip feel?A: Following hip replacement, you should notice a dramatic decrease in pain as compared to before your surgery. You will have post-surgical pain but that should decrease within 2-3 months. Your new hip will take a little getting used to, however the loss of the previous pain will more than make up for that.

For the longer term, be aware that your replaced hip might have the occasional discomfort or click, or there may be some mild numbness in the skin surrounding your healed wound. These are not issues to worry about. You have a new, artificial hip, which is less painful and more functional than your arthritic hip was.

Any recurrent symptoms, especially new consistent pain, should be looked into.
21. Q: What are the risks of hip replacement surgery?A: There are risks with any surgery. There are risks with almost everything we do in our lives, such as crossing the road, driving a car or getting on board a plane. The potential benefits of any surgery must outweigh the risks. The main ones that have concerned people are deep venous thrombosis, infection, instability and nerve injury. Just as in the risks with everyday life, precautions are taken to minimise the risks.
22. Q: Will there be a need for a blood transfusion after hip replacement?A: For primary hip replacement, less than 1 in 6 patients need a blood transfusion following surgery.

For revision hip surgery, it is more likely that blood transfusion will be necessary.
23. Q: What are the different types of knee replacements?A: The knee joint is made up of 3 compartments; the medial tibio-femoral, the lateral tibio-femoral and the patello-femoral.

Total  knee replacement is removal of all the articular cartilage (gristle) from all 3 compartments, along with the smallest amount of adjacent bone, and replacing it with artificial material.

Unicompartmental  knee replacement is the replacement of just 1 of the 3 compartments, provided only one compartment is affected by arthritis.

If 2 compartments are affected, then total knee replacement is the procedure of choice.

Bilateral refers to having both knees replaced under the same anaesthetic.
24. Q: What are the pros and cons of having both knees replaced at the same time?A: Having both knees replaced at the same time is a bigger procedure. However, the time in hospital and recovery times are not doubled. 

If both of your knees are equally affected by the pain of osteoarthritis, and you prefer the idea of one surgery only, then you are a candidate for bilateral knee surgery.
25. Q: How will my new knee feel?A: There is a great deal of variability in this. It is common for some numbness to be felt around your healed wound. The area of numbness is very different in different people.

Knee replacement patients typically take longer to recover from their surgery than hip replacement patients. Your knee will be better than what you had prior to surgery in over 95% of cases, but it takes a fair amount of “running in” to gain the full benefits, not unlike a new car. This “running in” period averages 3-6 months and can even take a year. During this time, regaining as much motion as you can, and getting your knee to straighten fully, will give the best results in the long run.

Your knee may make some clicking noises, which are not abnormal but can be disconcerting initially. Kneeling is not discouraged, but most people report back that they feel uncomfortable kneeling, and may prefer to avoid it.
26. Q: What are the risks of knee replacement surgery?A: Just like many everyday activities, surgery has some risks associated with it. The concerns that are most commonly expressed are deep venous thrombosis, infection, instability and stiffness (lack of movement). Precautions are taken to minimize the risks. 
27. Q: Will I need a blood transfusion after knee replacement?A: After having a unicompartmental knee replacement, transfusion is almost never needed.

After total knee replacement, about 1 in 6 patients need a blood transfusion. This is more likely after revision and bilateral knee replacement.