What Happens
on the Day of Surgery

Getting Started: Your Hospital Arrival

You will be asked to arrive approximately 2 hours before your scheduled surgery time. Our hospital staff will welcome you and guide you through the admission process. You will be asked to verify your personal details, insurance information, and consent forms. Please bring all relevant documentation — your referral letter, Medicare card, private health insurance details, and any medications you are currently taking.

You will then be escorted to the pre-operative ward. Our nursing team will check your vital signs — blood pressure, heart rate, temperature, and oxygen saturation — to ensure you are in good health for surgery. A hospital identification band will be placed on your wrist for safety and identification throughout your stay.

Getting Ready for Theatre

In the pre-operative area, you will change into a hospital gown and remove all jewellery, dentures, hearing aids, and contact lenses. A member of our anaesthetic team will visit you to discuss your anaesthesia plan — how you will be put to sleep, what to expect, and any specific concerns you may have. This is an excellent time to ask questions.

You will be asked about your fasting compliance. Standard fasting is nil by mouth from midnight, though we confirm this pre-operatively. With the advent of certain medications like Ozempic, Mounjaro and Wegovy, fasting instructions will change, as it is now normal to fast for 24 hours from food, and 6 hours from water prior to admission to allow for a safe anaesthetic. Please confirm your specific fasting instructions with us prior to admission. If you are taking blood-thinning medications, we will have discussed this at your pre-operative consultation. An intravenous cannula will be inserted in your arm — this is the line through which you will receive fluids and medications.

The surgical site on your hip or knee will be marked by either Dr Liew or a member of his team to confirm the correct side and site — this is a routine measure. You will then be transported to the operating theatre on a special bed. A member of our team will accompany you and remain with you until you are settled in theatre.

What Happens in Theatre

In the operating theatre, you will be positioned on the surgical table and monitoring equipment will be attached — heart monitors, blood pressure cuff, and pulse oximeter. The anaesthetist will ask you to take a few deep breaths of oxygen. You will feel drowsy and will drift off to sleep. General anaesthesia is a carefully controlled medical process — your breathing, heart rate, blood pressure, and oxygen levels are monitored continuously throughout surgery.

Once you are fully anaesthetised, Dr Liew and our surgical team will begin your procedure. For hip replacement, we always use the direct anterior approach — a muscle-sparing technique requiring a 5–6cm incision at the front of the hip. For knee replacement, we use a lateral curved incision designed to optimise both function and cosmesis. The procedure typically takes 1–2 hours, depending on the complexity of your case and whether you are having bilateral surgery.

Throughout the procedure, intra-operative imaging (X-rays) may be taken to confirm accurate implant positioning. This is part of our commitment to precision and longevity of your new joint.

Waking Up & Initial Recovery

As the anaesthetic wears off, you will gradually regain consciousness in the recovery room. You may feel drowsy, and some patients experience nausea — this is normal and manageable with medication. Oxygen will be administered, and our recovery team will monitor your vital signs closely. Pain relief will be administered as needed — do not hesitate to tell staff if you are uncomfortable.

Within the first few hours of recovery, our physiotherapy team may begin early mobilisation. This may include simple movements in bed, sitting up at the edge of the bed, or even standing and taking a few steps with support, depending on your surgery and overall condition. Early mobilisation is crucial for preventing complications and promoting recovery.

You will typically remain in the recovery room for 2–3 hours before being transferred to your hospital room. You will be given regular observations, pain management, and support as you continue to recover. Most patients take their first oral fluids — usually water or juice — a few hours after waking, and light meals may be offered later that day.