Dr Gallagher is a private surgeon who operates only in a private hospital. Without private health insurance, the cost of a simple arthroscopic procedure is prohibitive as patients would be required to pay the cost of the operating theatre and their day bed or overnight accommodation. Total knee replacement surgery without private health insurance can cost an uninsured patient over $25,000. These costs are picked up by health funds when patients have private health insurance.
As a general rule, there is an out of pocket cost payable for all surgeries and this is not claimable through Medicare or a health fund. In some circumstances however, Dr Gallagher may approve a No Gap or Known Gap surgical procedure however this is not normal practice.
In most cases, we require hip to ankle standing x-rays of both knees and an MRI of the knee in question and ideally, these need to be less than three months old. Our front office staff will liaise with all new patients to ensure they have the appropriate up to date imaging with them for their first appointment.
This will be different depending on your specific operation but can be up to six weeks following a knee replacement. It is dependent on a number of factors including mobilisation and medication and will be discussed with you prior to your surgery.
For arthroscopy – possibly for the day only and going home in the afternoon or overnight.
For ACL reconstruction – overnight.
For single knee replacement – usually for four nights.
For bilateral knee replacement – usually for five nights and we often recommend a short stay in the Rehabilitation Unit following this surgery.
You will need to bring your imaging, all paperwork, your Medicare card and private health insurance details and something to occupy you while you wait. If you are staying in the hospital, you will need pyjamas and personal toiletries.
This depends on patient factors including age, activity level and body mass index with a 95% likelihood that it will still be working well in 10 years if you are over 55 years of age compared to patients less than 55 years of age having only an 80% likelihood doing so. With recent advances in implant technology and improved surgical technique, many knee replacements are now expected to last for up to 20 years or longer.
This will vary depending on the type of surgery, how you are mobilising, how you are feeling within yourself, and the type of work that you do. As a general principle, total knee replacements will require you to be away from work for a minimum of 4 – 6 weeks. For an ACL reconstruction, this might be 2 – 3 weeks and for an arthroscopy, 1 – 2 weeks off work. If you are on your feet a lot at your place of work, these times may well need to be longer.
Dr Gallagher prides himself on a very low infection rate however for various reasons, infection can occur. Signs to look out for include localised redness, persistent weeping from the wound, increasing warmth and swelling, sweats or fevers, increasing pain and / or feeling unwell. Dr Gallagher is to be notified urgently if any of these signs are present and if this is after hours, his mobile number is printed on the bottom of the post operative notes.
Yes, after knee replacement surgery, the normal reflex control arising from the nerve fibres within the ACL is lost and the hamstring and quadriceps muscles do not co-ordinate as well as before the procedure, allowing the femoral and tibial components to roll back and forth upon the rigid plastic insert separating them, making this clunking sound. It will usually resolve in time by itself but can be improved more swiftly with some quadriceps and hamstring strengthening and co-contraction and proprioception drills to enhance co-ordination and reflex control.
The peak period of thromboembolic complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE) following surgery is within the first 10 to 20 days but can occur several weeks or months later. As such, if you are flying within the first 3 to 6 months after surgery, physical and chemical prophylaxis is recommended using compression stockings (TEDs), calf and foot pump exercises, elevation where possible, in flight mobility and use of self administered heparin injections (Clexane) – or if this is not possible – low dose aspirin or an alternative oral anti coagulant (Eliquis or Xarelto).
Any dental work should be carried out a minimum of 2 weeks prior to surgery to allow the mouth to heal and at least 3 months but preferably 6 months following surgery to avoid blood borne spread of oral bacteria to the knee. Patients should have antibiotic cover 30 minutes before going to the dentist. Most patients will receive 3gms of oral Amoxil if they do not have an existing allergy or any other contra indication.