Clinical Resource

1. Clinic Schedule
2. Operative Schedule
3. Our Services
4. Patient education

1. Clinic Schedule

2. Operative Schedule

3. Our Services

Joint Replacement Services

We provide Hip and Knee Replacement for various types of knee and hip pathologies, especially those related to primary and secondary Osteoarthritis and Rheumatoid Arthritis.

Spine Services

We are managing pathologies involving the spine, leading to back and neck pain. This includes innovative nonsurgical and surgical treatment options.
We also offer conventional and minimal invasive spine surgery for various types of spine disorders by integrating our knowledge and research into a treatment plan, tailored to each specific patient and disorder.

Trauma Service

The orthopaedic trauma service is responsible for the management of patients who have sustained injuries to the musculoskeletal system. We are treating patients with common fractures as well as patients with multiple fractures. Our area of expertise includes managing upper and lower limbs fractures, as well as pelvic and spine fractures. We offer the latest and innovative techniques in orthopaedic surgery, comprising various types of conventional and latest implants base on patient’s need.

Sports Service

Our trained surgeons are dedicated to the treatment of knee, hand, elbow and shoulder problems. This includes both nonsurgical and surgical treatment of these conditions. Our surgeons have extensive experience in sports injuries, reconstructive surgery, arthroscopy, as well as joint arthroplasty.

Other Services

We also provide treatment for general orthopaedic conditions, including orthopaedic infections of the upper and lower limbs such as cellulitis, septic arthritis and abscesses.

Total knee/hip replacement

Diseases, such as knee osteoarthritis damage your knee/hip surfaces and surrounding cartilage, causing great pain and impairing joint function. Total knee/hip replacement evidently improves your quality of life and health. However, the decision to have total knee replacement surgery should be made very carefully after consulting your doctor and learning as much as you can about the knee joint, arthritis and the surgery.

Preparation

It is vital to have a complete preoperative assessment a couple of weeks prior to the surgery to rule out any other medical problems that may interfere with your surgery. At this time, your doctor also will take your medical history and order various tests that must be performed before surgery, such as blood tests, urine test, chest and knee X-rays and electrocardiogram (ECG).

Be sure to tell your orthopaedic surgeon about all medications that you are taking. They will then advise you on which medications you should continue or stop taking prior to surgery. In addition, if you develop any kind of infection prior to surgery, such as a cold or the flu, notify your surgeon immediately.

You should be in the best possible health before your surgery. If you are overweight, your doctor may suggest that you lose weight. If you smoke, it is highly recommended that you stop prior to your surgery because smoking can change blood flow patterns and delay healing and recovery.

Ten days prior to surgery, you should stop taking blood thinners ( e.g aspirin/ticlopidine/clopidogrel etc ). This is to prevent excessive bleeding intraoperatively

Funding

Once your surgery has been scheduled, it is vital to get necessary financial and funding in hand. Your orthopaedic surgeon would prescribe you with the implants that fit you the most. This will be accompanied with the quotation of the implants from the respective implant company.  For government servant or retiree, the cost for the operation along with the implant can be covered by JPA. Certain forms need to be filled which will be described to you during your clinic sessions. Other financial assistance such as tabung bantuan perubatan are also available.

Admission to hospital

In most cases, you will be admitted 2 days pre operatively. This is to allow thorough physical examination and investigations before the surgery. Any discrepancy in your current medical condition e.g. blood pressure needs to be treated. You will also be assessed by the anaesthetic doctors before surgery.

Several blood tests and ECG will be taken. You will be asked to sign a consent form for surgery. Make sure you understand the whole procedure and its risks well before signing on the dots.

You may not eat or drink anything after midnight the night before your surgery. You will be given 2 bottles of chlorhexidine (a pink colour solution) that you need to apply during shower the evening before and the morning before surgery. Try to rest and go to bed early.

A reading material regarding post operative care and physiotherapy will be given to you by admitting staff nurse.

Procedure

The damaged bone surfaces and cartilage are removed and replaced with artificial surfaces made of metal and a plastic material. These surfaces are called "implants" or "prostheses" and restore the alignment and function of your knee. A total knee/hip replacement takes about two hours. Please ask your orthopaedic surgeon if you need further explanation.

Recovery

After surgery, you will be taken to the recovery room and monitored for several hours before being taken back to your room. You will be monitored closely in the high dependency unit.  Usually, you will remain in the hospital for three to four days, depending on your recovery. It is normal to feel some pain that will be managed with medication to make you as comfortable as possible. To avoid lung congestion after surgery, you should breathe deeply and cough frequently to keep your lungs clear.

Post operative X-ray of the knee/hip will be taken day 1 after the surgery.

Possible Surgical Complications

Serious infections, such as a knee joint infection, occur in less than 2 percent of patients. The surgery will be done in a completely sterile (bacteria free) environment. You will be given antibiotics before the surgery and after the surgery.

Blood clots in the leg vessel are notable complication of knee replacement surgery. It could be life threatening. You will be given injection of blood thinner to prevent this from happening. You need to continue giving this injection for 2 weeks after surgery. Apart from that, there are several other ways of prevention of clots formation such as regular feet exercises, wearing TED stockings and also intermittent compression/foot pump that will be made available to you throughout your post operative stay.

Keep in mind that the rate of medical complications following knee/hip replacement surgery is extremely low.

Physiotherapy

Walking and knee movement are very important for recovery. Usually the first day after surgery, is your rest day. Then you'll begin to work with a physical therapist who will teach you exercises to regain full leg and knee movement. During your hospital stay, you will be attended by a physiotherapist every day. An occupational therapist and nurse discharge planner will help you prepare for your return home.

Your doctor may recommend a continuous passive motion (CPM) machine that bends and straightens your knee.

Post-Hospital Care

Once you return home, it is very important to follow your orthopaedic surgeon's instructions, particular during the first few weeks after surgery. You'll have staples running along your wound. These will be removed weeks after your surgery. Before leaving the hospital, your incision will be covered with a dry dressing. You should change the dressing as instructed and avoid getting it wet until your wound has healed.

Being physically active is an essential part of recovery. Within three to six weeks, you should be able to resume most normal physical activities. You will be given physiotherapy follow up appointment during the first few weeks of recovery. Do not push yourself, do not get too overexcited and make sure you do not fall.

Follow up

During the first year after surgery, routine follow-up visits are scheduled with your orthopaedic surgeon at two weeks, six weeks, three months, six months and 12 months. You'll be asked to return for annual visits to assess the status and function of your implant.