17 points: The checklist for your operation

An appointment at our outpatient clinic, referral by your orthopedist or surgeon. Important for patients resident in Germany with compulsory insurance: Please don't forget the referral slip and your insurance ID card.

Outpatient clinic check-up with examination, x-rays if necessary, diagnosis, discussion of therapeutic possibilities. Please bring along current and, if available, older x-rays as well as any other relevant diagnostic findings.

If surgery is needed, information about the operation, the scheduled week for the operation, if applicable the dates arranged for preliminary discussion and blood donation. The referring doctor receives all relevant data in an informative letter.

Appointment with the blood donation department, usually the same day as the first visit. Here you will also receive a questionnaire concerning anaesthesia.

About ten days before surgery a telephone call from our secretary to your home to fix the exact date you will be admitted to the clinic. Pre-operative assessments (chest x-ray, ECG, lab test results) can either be carried out by your own doctor or done here at the clinic. Please make sure your family doctor or internist gives you a general pre-operative check-up before you come.

If you take blood thinning medication or medication that affects blood flow (e.g. ASS, aspirin, Colfarit, Marcumar, etc.) it has to be stopped well before surgery. Please talk to your family doctor or us about this to determine the right time for the possible change in medication.

You will normally be admitted to the hospital the day before surgery.

Please bring with you:

• Your medical records (medication, doctors letters and findings etc.) 
• Your insurance card (if applicable) 
• Referral for in-patient treatment by your home physician 
  (only for patients resident in Germany)
• The address of your insurance company 
• The address of your family doctor 
• The address of your referring orthopaedic consultant (if applicable) 
• Crutches or other walking aids, if you already have them

The first stop in our clinic should be the hospital admission department (please ask at the front desk). Keep your referral slip (patients resident in Germany only) and your insurance card handy. You will then be shown to our in-patient admission centre, which is located right next to Mr Schlemmer's offices on floor 0 in the south wing.

Apart from your personal belongings we recommend you bring the following with you:

• Dressing gown or bath robe
• pyjamas/nightdress
• sweat shirt and jogging pants with wide cut at the ankles for easy entry
• sturdy, closed shoes with non-slip rubber soles, preferably slip-ons
• Very long shoe horn
• long pair of tongs (e.g. barbecue tongs)
• swimming costume or trunks
• any medical devices you currently use (walking aids etc.)
• if possible and applicable bring hand towels, mouthglass, 
  containers for dentures, contact lenses etc. with you

Preparations for the operation will be carried out on the day you are admitted. If there are no diagnostic findings that make further examinations necessary, operation will normally take place on the following day.

For joint replacement surgery you should expect to be at the centre for around 14 days, with another optional 14-21 days in a rehabilitation centre.

Surgery is performed, in line with the pre-operative findings and your wishes, with general or partial anaesthesia. The anaesthetist will discuss this with you in detail. Please bring along the completed anaesthaesia form you received on your first visit.

You will usually get out of bed one day after a joint replacement operation and make your first attempts to walk using crutches. These activities will be gradually increased in the following weeks. You will be free of crutches about 4 to 6 weeks after your operation.

We will plan your stay at a rehabilitation centre with you during your stay as an in-patient, registering you at the selected clinic, since the right post-operative treatment is as important as the operation itself. There are a number of rehabilitation centres available. We generally recommend the Dr. Beger Clinic in Garmisch-Partenkirchen because their treatments are carried out in close coordination with our wishes and we can visit you there twice a week.

At the end of your treatment as an in-patient at the rehabilitation clinic you might require additional physiotherapy. It is best to speak about this before your operation with your family doctor or orthopaedic consultant and select an appropriate specialist. If possible visit the respective therapy centre to get acquainted with the premises. Take care when selecting a therapist that amongst other things they have the special expertise needed for the treatment of joint replacement patients.

We will normally give you a medical certificate for a period of three to four months following joint replacement.

The first check-up as an out-patient takes place some three months after surgery. A further check-up after one year and then at two-year intervals are advisable. Regular checking by your surgeon can be important for the longest possible, trouble-free functioning of your joint: he can see possible changes early, at the onset, and if necessary treat them.