Orthopaedics 360

Surgeons, physios, and a robot walk into a room… 🤖
A brilliant education night with the PhysioXtra and Eastwood Physiotherapy Clinic teams — a tour of our new rooms, shared learning, and a live, hands-on demo of the Mako 4 Robotic System we use at Eastwood Private Hospital.
Surgery is only half the story — recovery is the other. When both teams work this closely, patients get the best of both.👏
Our surgeons: Dr Luke Mooney, Dr Raymond Yu, Dr Mike Smith and Dr Chien Wen Liew.
.raymondyu Dr. Luke Mooney Eastwood Physio and Rehab Clinic

Surgery day can feel daunting. Most patients tell me afterward that it was much calmer than they expected.

Here is how the day typically unfolds.

You arrive at Eastwood Private or Calvary Adelaide Hospital (The two newest ones in Adelaide) and get settled into the pre-op gowned wait area. The anaesthesia team comes by to introduce themselves and go over the plan in holding bay. We always check things multiple times - Name, DOB and side for surgery - it's just part of the routine. We never make mistakes because we follow set protocols. I visit before you go to theatre to answer any last-minute questions.

The operation itself takes around 60 to 90 minutes for a primary joint replacement. You spend a short time in recovery, then return to your room.

Within a few hours - or the morning after at the latest - the physiotherapist gets you up and walking. That first walk is usually the moment patients realise the joint already feels different.

Hospital stay is typically 2 -3 nights for a single hip replacement, and up to 3 nights for a knee replacement or bilateral hip.

A few things to prepare: have your prescriptions filled before admission, have someone stay the first night at home, and set up a firm chair with armrests you can push off from easily. Make sure you have a good supply of food at home, and queue up some movies to watch, or books to read. The first few weeks are just short walks, regularly, icing and elevation.

drchienwenliew.com.au

A question that comes up regularly in clinic, especially for patients planning travel or interstate visits after surgery: when is it safe to fly after hip replacement?

The main concern with flying is deep vein thrombosis (DVT). Surgery increases the risk of blood clots, and prolonged immobility in a plane cabin compounds that risk. This is why timing matters.

For most patients, I advise:

DOMESTIC FLIGHTS (under 4 hours): typically safe anytime after surgery. We have many patients who fly in from all over Australia, who decide to stay in Adelaide a few days after discharge, and then fly home. This is absolutely fine. You will have blood thinners on board, compression stockings, and you should be walking reasonably well.

LONG-HAUL FLIGHTS (over 4 hours): I recommend waiting a minimum of 4 weeks. At this stage, you are walking well, and the blood clot risk has reduced significantly. It's not quite normal as yet, but the risk is far lower.

Even so, there are sensible precautions:

Book an aisle seat so you can stand and walk every hour without disturbing others. Wear compression stockings for the full duration of the flight. Stay well hydrated and avoid alcohol. Perform the exercises that you were given - especially toe wriggling, ankle pumps etc, regularly, whilst on the flight. And it is recommended to take an Aspirin 100mg before take off, and one on landing as well after longer flights. It will thin the blood slightly, and reduce your risks.

If you have had a blood clot before, avoid long flights for 10-12 weeks post op.

The same principles apply to long car trips and cruises. It is the prolonged sitting, not the altitude, that creates the risk.

If you have a specific trip planned, let me know at your pre-operative or post-operative visit and we can plan around it.

drchienwenliew.com.au/learn-hip

One question I get asked in clinic almost every week: "Is recovering from a hip replacement the same as a knee?"

The short answer is no. Here's what Ive found.:

HIP REPLACEMENT

Hip replacement recovery is generally faster than most patients expect. I perform a direct anterior approach with minimal soft tissue damage, which allows most patients to be up and walking on the day of surgery. Pain is usually well managed with simple medications. Most patients are off their walking aids within 2 weeks and drive within 2-3 weeks. With hips, it's often me holding patients back - stopping them from overdoing it. The bone needs to grow into the implant which takes about 6 weeks for a meaningful attachment so we don't do anything heavy until then.

The early focus is on allowing the swelling to decrease, the internal inflammation to settle, and allowing the bone to grow into the implant. Whilst you won't feel that happening, and everything will feel good, it still takes time and there is nothing patients can really do to speed up the biology of it all.

KNEE REPLACEMENT

Knee replacement takes a little more time and more work. The knee is a more complex joint to rehabilitate. You need to regain range of motion, manage swelling, and retrain the surrounding muscles, all at the same time.

In my practice, I use a kinematic alignment approach for knee replacement. Rather than placing the implant in a fixed mechanical position, I align it to restore the natural anatomy of your knee. This means the joint moves and feels more like your own knee, and patients tend to recover better range of motion compared with conventional techniques.

The key to a good knee outcome is early, consistent physiotherapy. The first 6 weeks are critical. Patients who do the work in that window consistently do better at 3 and 6 months.

WHAT I FOCUS ON FOR BOTH

Regardless of which joint we are replacing, I focus on a few things for every patient:

Getting you ready before surgery. Nutrition matters: protein, iron, and vitamin D all affect how well you heal. Some people find zinc helpful for the wound. I actually really like Creatine and Glutamine for recovery. Optimising any medical conditions beforehand. Making sure you know exactly what to expect, so there are no surprises. Setting a realistic timeframe. Most patients are doing what they want to do by 3 months, but full recovery takes closer to 9.

If you are thinking about either procedure and want to understand your options in more detail, I have dedicated information on both on my website.

Hip replacement: drchienwenliew.com.au/learn-hip
Knee replacement: drchienwenliew.com.au/learn-knee

I am happy to give you an honest assessment of where you are and what makes sense for your situation.