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Please read carefully the information provided below. It is essential that you are familiar with all the steps of your treatment. This will ensure the greatest satisfaction and best possible result of the proposed treatment. The information provided is specific to Mr Vioreanu's practice. All the aspects below will be discussed in depth during the consultation.
First Consultation
During first Consultation you will meet Mr. Vioreanu to discuss your knee problem. He will determine what, if any, surgery is required.

The consultation will last as long as necessary, depending on the complexity of your knee problem. Mr. Vioreanu will perform a physical examination and will review all your imaging studies.

There is a fee payable for the Consultation. Remember to bring the referral letter from the GP or medical specialist.

Appointments are realistically scheduled for all patients, mindful and respectful of time. The nature of medicine and surgery is not always predictable and delays might happen. Your understanding is appreciated during such circumstances.

Appointments are confirmed with an SMS alert the day prior. A cancellation fee is not charged, however a return phone call of inability to attend is appreciated.
Do I Need Surgery?

Arthroscopic knee surgery is generally a safe operation with minimal complications. However there is no such thing as a ‘small operation’. Mr. Vioreanu will discuss in depth the natural course of your knee problem and the expected results with all treatments available to you. This will allow you to be actively involved in the decision-making process and make an informed decision on what is the best treatment option for you. Whenever possible and indicated Mr. Vioreanu will advise non-operative treatment first. The ‘Rationale for Treatment’ is outlined in the Patient Information brochures for the more common knee pathologies possibly requiring arthroscopic surgery.


Arthroscopic Meniscectomy Arthroscopic Meniscectomy (697 KB)

Arthroscopic Treatment of Knee Osteoarthritis Arthroscopic Treatment of Knee Osteoarthritis (805 KB)

Risks for Surgery
There are always risks when having surgery, and you need to be fully aware of those risks before making your decision to proceed with surgery. Do not hesitate to ask questions of your surgeon, anaesthetist or of other medical specialists who are managing your health in the lead up to your surgery.

The vast majority of people get through the surgery with no problems at all and will be surprised at how good they feel so soon afterwards. Some will experience minor issues and occasionally there may be more serious complications. These problems are rare and most can be treated quickly and effectively. Below is a list that covers the major risks and complications with Arthroscopic surgery. Additionally, there may be other risks, particularly if you have a complex medical history or particular conditions which need to be managed by a medical specialist.

  • Pneumonia: Patients with a viral respiratory tract infection (common cold or flu) should inform the Surgeon as soon as possible and will have their surgery postponed until their chest is clear. Patients with a history of asthma should bring their inhalers to hospital.
  • Deep vein thrombosis and pulmonary embolus: Although this complication is rare following arthroscopic surgery, a combination of knee injury, prolonged transport and immobilisation of the limb, smoking and the oral contraceptive pill or hormonal replacement therapy all multiply to increase the risk. Any past history of thrombosis should be brought to our attention prior to your operation. The oral contraceptive pill, hormonal replacement therapy and smoking should cease one week prior to surgery to minimise the risks.
  • Excessive bleeding resulting in a haematoma is known to occur with patients taking Aspirin or Non-steroidal Anti-Inflammatory Drugs - such as Voltaren, Arcoxia, Mobic, Naprosyn or Indocid. They should be stopped at least one week prior to surgery.
  • Infection. Surgery is carried out under strict germ free condition. Antibiotics are administered intravenously at the time of your surgery. Any allergy to known antibiotics should be brought to the attention of your Surgeon or Anaesthetist. Despite these measures there is a less than 1 in 500 chance of developing an infection within the joint.
Before Surgery

Choosing a date for surgery

After the consultation in conjunction with Mr. Vioreanu Personal Assistant, you should decide on the time frame and a date that is most suitable to you. You will find that we are very flexible and will try to accommodate your requests whenever possible.

Forms to be completed and signed.

You will receive an information package containing your admission, consent and questionnaire forms, which you will need to complete and sent back to us.

Mr. Vioreanu collects information about each surgery for the purposes of patient management, but also uses information for research. You will be given a consent form, which is to be completed and given back to Mr. Vioreanu’s office.

Let us know.

You should inform us of any medical conditions or previous medical treatment as this may affect your operation.
It is extremely important that there are no cuts, scratches, pimples or ulcers on your lower limb as this greatly increases the risk of infection. Your surgery will be postponed until the skin lesions have healed.
You should not to tape, shave or wax your legs for one week prior to surgery.
Please use HIBISCRUB solution (Chlorexidine 4%) to wash your knee ONCE daily for 5 days prior to surgery. Wash the skin gently and do no scrub the area. You can find HIBISCRUB solution at a retail Pharmacy. 


Pre-operative testing.

You will receive a list of all pre-operative tests required prior to surgery. These are standard tests for all patients.

Managing your Medications.

Prior to your surgery we will discuss your medications with you. You will be given important instructions about what you should and should not take prior to surgery. Please do not hesitate to contact our office if you are unsure about these instructions.

Also, some patients with complex medical conditions will need appointments with other medical specialists to ensure that it is safe to proceed with surgery.
We will let you know if this is something you need to do.

Physiotherapy & Crutches.

As this is a day-procedure in most cases you will see a Physiotherapist in SSC before heading home. A set of crutches will be provided by SSC after surgery.
They will ensure you are walking safely with the aid of crutches and will give you instructions for the next few days. 

We strongly advise that you arrange to see your local Physiotherapist the first few days after surgery. 

Please inform us the name of your local Physiotherapist so we will communicate with them regarding your rehabilitation program.

The night before surgery.

Please do not eat and drink after mid-night and try to have a good nights sleep.
During Hospital Stay

Admission to SSC.

You will be admitted on the morning of the surgery. Mr. Vioreanu Personal Assisstant will inform you of the exact time and place to go for your admission.
Do not forget to bring all your relevant imaging studies (Xray’s , MRI’s etc.) and relevant medical letters and tests.

Immediately after surgery.

You will wake up in the recovery ward and will have a bandage on the operated knee. As Mr. Vioreanu uses locally targeted pain control you will find there will be little or no knee pain. A nurse will be with you administering oral pain-killers if necessary. Mr. Vioreanu will come and discuss the surgery performed and will ensure all instructions for the post-operative period are clear. A physiotherapist will visit you and will help you getting out of bed and walk with the assistance of crutches. When you feel ready to go home, make sure that before leaving SSC hospital you have the prescription for the pain-killers and the post-operative instructions including a date for the follow-up appointment with Mr. Vioreanu.

SSC In-hospital Handbook SSC In-hospital Handbook (1451 KB)

After Surgery

Day 1

Please see your local Physiotherapist and follow her instructions for gentle mobilization.

The next few days.

If you have any concerns about your post-operative recovery please do not hesitate to contact our office. Mr. Vioreanu will call you back at a suitable time to discuss all your concerns.

Swelling.

The swelling in your knee will reduce progressively over the first two weeks following surgery.
If you are up and moving about, it is normal that the swelling and bruising will gravitate down to your ankle. 
To reduce swelling and bruising place 2-3 pillows under your bed mattress to keep the leg elevated at night time.

Crutches.

You should discard crutches a few days after surgery when walking comfortably if not advised otherwise by Mr. Vioreanu ( In case of Microfracture procedure you should be on crutches for 4-6 weeks).

Bandages.

Bandages should be kept on for 10-14 days until the wounds are fully healed. If the bandages get wet you can change them with the ones you were given at your discharge from the Day Ward. If you notice any discharge or are worried about the wound report to your GP or attending Physiotherapist. 

Driving.

Driving is permitted when you are able to walk without crutches  and you are off medication
Driving an automatic car is possible as soon as pain allows after LEFT knee surgery.

Exercise & Return to Sport.

You should begin gentle exercise as advised by your Physiotherapist. We advise that you begin cycling on an stationary exercise bike at home during the first few days after surgery. This should be light and comfortable exercise. If you experience excessive pain stop exercising and contact our office if any further concerns.
Return to sport largely depends on your surgical findings and outcome. You will discuss this in depth at the follow-up consultation with Mr. Vioreanu.
Follow-up Appointments

Mr. Vioreanu will see you 2-3 weeks after arthroscopic knee surgery. You will be given details of the Follow-up appointment at discharge from the Day-Ward following your surgery. Generally after knee arthroscopic surgery this the only scheduled follow-up appointment. However if you encounter any problems or have any concerns please contact our office for a new appointment.


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