Having a knee operation? Then you’ll almost certainly be having a pre-operative assessment too.
If this is the first time you’ve ever had surgery, that may leave you with some questions. Haven’t you already been assessed at your appointment with the surgeon? What’s different about this one – and what does it actually involve? Here’s an overview of everything you need to know…
(Want the quickest answer? Scroll down to What happens during the pre-operative assessment? below!)
What is a pre-operative assessment?
A pre-operative assessment is a detailed health check that happens in the run-up to your operation, to make sure you’re fit for surgery and to plan your care. It’s usually led by a nurse, though sometimes involves an anaesthetist or other specialist if your case is more complex. The name actually varies a bit depending on who you talk to! You may also hear it called a pre-assessment appointment, a pre-admission clinic, a pre-assessment or simply a pre-op. They generally all refer to the same thing.
How is it different from my surgeon appointment?
The initial consultation you have with your knee surgeon is focused primarily on your knee problem: what’s going on inside your joint, how can we confirm the diagnosis, and what can we do to solve it for you? The pre-op is about the overall health and fitness of your whole body, and whether surgery – if we think you need it – is appropriate for you.
Why do I need a pre-op assessment?
Pre-ops are a standard part of the hospital process. If you’re having a procedure, even a relatively minor one, your medical team want to make sure they’ve given you the proper checks before it goes ahead. The main questions they want to answer are:
Fitness for surgery – is it actually safe for you to have this operation? Is there anything that might stop it from going ahead?
Medical issues – do you have any other needs or health conditions that might change our approach to the procedure?
Information – do you have a clear understanding of what the operation and your rehab involves?
Reassurance – do you have any questions or worries about the surgery? (This is a good opportunity to share them!)
When will I have the pre-op assessment?
Most pre-ops happen about 2-4 weeks before your operation. This allows us to pick up any changes that might have taken place since your original consultation with the surgeon; let’s say, if you started taking a new course of medicines, or had to receive treatment for a heart condition in the interim. It also gives us time to carry out some physical tests and investigations (see below), and to analyse the results from them, to see if we need to change your care plan.
What is the “pre-operative questionnaire”?
This is basically an early triage tool to help us find out more about you and your general health. Unlike your assessment, it might happen several months before surgery; in fact it usually takes place soon after your initial consultation. Its main purpose is to get a fuller picture of your health, so we can decide which tests you might need to take during your pre-op. It will ask you about everything from your height and weight to any medicines and dosages you’re taking. It takes about 15 minutes to complete.
Will you send me the questionnaire?
You may get a printed form to fill out after your consultation. But these days the questionnaires are often done online. Many NHS trusts use Synopsis, a secure platform that lets you tap out your answers on a computer or phone, before sending them to your medical team for review. (These questionnaires are also helping to streamline the surgery process and reduce waiting times. You can watch some of our local doctors and nurses explaining more about how they work in this video: Synopsis at Hampshire Hospitals NHS Foundation Trust.)
Where will I have the pre-operative assessment?
This depends on the type of procedure and anaesthetic you’re having, plus your age, fitness and medical history. If it’s a minor procedure, or if you’re young and don’t have other health complications, you may be able to do the assessment by phone or on a video call. Otherwise, we’ll ask you to come to the hospital for a face-to-face appointment. Bear in mind that, even if you do have a remote assessment, you may need to come in later for tests or physical checks. Your appointment letter will tell you whether you can have the main assessment by phone or in person.
What happens during the pre-operative assessment?
Every pre-op assessment is tailored to the individual patient, so the answer to this varies depending on what you’re having. But it will cover at least some of these areas:
Medical history – The nurse will ask you some detailed questions about your general health, any health issues or surgery you’ve had in the past, and your home circumstances (for instance, if you live alone but are having a major operation such as a knee replacement – they’ll want to help you be well-prepared ahead of time).
Vital statistics – If you’re attending an in-person assessment, we’ll record your “baselines” – things like your blood pressure, pulse, oxygen levels, temperature, respiratory rate, height, weight and body mass index (BMI).
Medication – If you’re taking any medicines, we’ll want to know all about them so we can tell you whether to pause, adjust or keep taking them in the lead-up to surgery. It’s a good idea to have this ready for your appointment; write down a list of any medicines or supplements you’re taking, when you take them, and what dosages.
Physical tests – In hospital, we may ask you to take some routine tests. Some of the common ones include: blood tests, to screen for any potential issues; urine tests; an electrocardiogram (ECG) for your heart; and a swab test to check for infections like MRSA (a bacteria that’s usually harmless on the skin but can cause serious infections if it gets into wounds).
Referrals – If you have another known health condition, we may refer you to a specialist for further advice about the operation. Sometimes a test result can flag up something that needs further investigation too, so you might be asked to have a separate test, such as a liver function check or an echocardiogram (another type of heart scan).
Advice – The pre-operative assessment is also a key opportunity to get more detailed information about your surgery. You’ll receive instructions about how to prepare for surgery, when to stop eating and drinking before the operation, your transport plans for getting back home afterwards, who will care for you after discharge, and any special hygiene requirements. You can also share any questions, concerns or worries you have with the nurses. Again, it’s worth writing these down so you can cover everything when you speak to them.
How long does it take to do a pre-operative assessment?
Again, it varies. But we generally recommend that you set aside 45 minutes for an assessment by phone, and up to two hours if you’re coming into the hospital for a face-to-face appointment. The two hours generally covers the time we need for your tests and check-ups.
What do I need to bring with me to the assessment?
There are a few things you may need to bring with you on the day – or have ready if you’re doing a phone assessment. These include:
- Medicines – as mentioned, write down a list of any medication you’re taking, the doses, and when you take them
- Paperwork – if you have any recent letters, scans (such as an X-ray) or test results, it can be helpful to have them with you
- NHS number – it’s a good idea to write this down and bring it with you
- Comfortable clothes – if you’re due to have an ECG you may need to partially undress for the test, so it’s helpful to wear loose-fitting, layered clothing to the hospital (you should also avoid applying any oils or moisturisers on the day of your appointment, because these can interfere with the ECG)
Are you weighing up whether to have an operation on your knees – or struggling with knee pain and wondering if you might need one? We’re here to help. You can make an appointment here at Chris Bailey Orthopaedics by phone, email or with our online booking form. Whatever problems you’re facing, we’ll be delighted to help you get the diagnosis, advice and support you need.
