Andy Cossey – Knee Surgeon Portsmouth


Frequently Asked Questions

It is important to us you feel involved in your decision making. Having surgery can often be an anxious time. We hope this section will answer some of your questions, giving you confidence in our skill.

It is difficult to anticipate every question as every client is individual. Should you have any further questions that have not been answered on this page, please feel free to contact Julie directly and she will be happy to help.

What is an arthroscopy ?

A knee arthroscopy is keyhole surgery which is performed as a day case and in most cases you will be able to return home with minimal disruption to your normal activities.  It enables me to assess your knee and confirm a diagnosis which has already been provisionally made both clinically and radiologically.  the common arthroscopic knee procedures include meniscectomy, chondroplasty, meniscal suture and removal of other soft tissue structures.   The procedure takes approximately 45 minutes and you will need a general anaesthetic .   You will leave hospital on crutches usually fully weight bearing and it is recommended that you have a minimum of one week off occupational activities post surgery.

What is a knee replacement?

A knee replacement is a major operation and involves relining your natural knee an artificial metal based implant.  The operation requires an anaesthetic and this usually takes the form of an injection in your back with a supplementary injection into your groin (regional anaesthesia).     You will spend approximately 3 to 4 nights as an inpatient and require crutches for four to six weeks post surgery.   It is essential during this initial period that the swelling is reduced and the range of movement encouraged usually with the help of your local physiotherapist.

What is an Anterior Cruciate Ligament (ACL) Reconstruction?

An ACL reconstruction is the most common knee ligament to be surgical reconstructed.  It usually involves the use of your own hamstring tendon, this tissue is then threaded through your knee to take the place of the ruptured ligament.  The surgery is done under a general anaesthetic and you usually require a one night stay in hospital.  Following your hospitalisation it is imperative that a rigorous exercise programme is undertaken supervised by your physiotherapist.  The end surgical result takes between six to nine months to achieve.

What happens before my surgery ?

The operation will be explained to you in detail at your consultation with Mr Cossey who will also ask you some questions required by Dr Bali, your personal anaesthetist.

Dr Bali will contact you prior to your surgery to go through this information and to answer any concerns you may have regarding the procedure.

Julie Chaffey will speak with you following your consultation and decision to proceed with surgery. Julie will work with you to secure  you a convenient date for surgery that suits your occupational and social commitments.  She will also provide insured patients with all the information they need to gain authorisation from their insurer and, is happy to speak directly to any insurance company should they require further details.

If you wish to arrange payment personally for surgery Julie will be able to advice of the necessary steps. Julie will also liaise with the hospital who will then send you details of the financial packages they have available, should you require.

The hospital will contact you to confirm your booking, send you details of all your admission arrangements and what to do on the day of surgery. You will be sent full instructions regarding eating and drinking restrictions necessary for surgery.  Some patients require a pre-operative assessment which takes place at the hospital. If you require one of these appointments the hospital will contact you directly and book this for a week prior to surgery.

What happens on the day of surgery?

You will be admitted to hospital on the day of your operation. Our operating times can vary so you asked to arrive any time between 7.00am and 11am on the day of surgery.The hospital will provide this information well in advance of the surgery date so that you are able to make personal arrangements.

When you arrive at hospital you will be welcomed to the ward and shown your room. You will be provided with a gown by the nursing staff ready to prepare for theatre.

Both Mr Cossey and Dr Bali will come and see you before the operation and will run through the procedure and will  discuss any other queries, questions or concerns that have not been discussed previously.  Your surgery site will be marked with an arrow and your final consent obtained.  You will be taken to theatre where you will see Dr Bali who will then carry out the anaesthetic.

Once the operation is completed you will spend time in recovery being attended to by the nursing team and returned to your room when you are ready  and comfortable to move.


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What anaesthetic is used ?

Dr Bali will discuss your anaesthetic requirements when she contacts you prior to your admission.  In most cases a general anaesthetic is used.  Mr Cossey will also be happy to discuss any anaesthetic concerns with you at your consultation and will liaise directly with Dr Bali should you have any specific concerns or questions.

What pain relief is offered ?

Pain relief is paramount to us and more importantly you.  The amount of pain relief will largely depend on what surgery is undertaken and will be discussed with you prior to surgery.  All patients are given an injection of local anaesthetic into the knee at the end of a procedure.  This provides excellent pain relief for up to 12 hours following an operation.

With major surgery such as a knee replacement, other pain relieving techniques are used for your maximum comfort which can range from a spinal injection or pain killing infusion.  Your continued pain relief either on the ward or at home, will be discussed and a plan formulated to ensure your post operative journey goes as smoothly as possible.  Advice will be given both during your hospital stay and prior to being sent home regarding your pain relieving medication.

What are the risks involved with my surgery?

All surgical procedures carry risks and however small these will be outlined to you at the time of your consultation once a decision to proceed with surgery has been taken.  The main risks involved with knee surgery are:  infection, thromboembolic, superficial nerve injury, vascular injury, implant failure, swelling, stiffness and lack of therapeutic response. Mr Cossey will explain these risks to you fully and will answer any questions or concerns you may have relating to any one of them.

What happens after my surgery ?

Once your surgery is over and you have left the recovery suite you will be taken back to  the ward where  you will be monitored closely by the nursing staff. Your knee will be dressed with a bulky bandage and possibly a knee splint depending on the surgery that has been undertaken. For major knee surgery such as a total knee replacement you may have a drain that measures post operative bleeding. The drains do not stay in for long and are usually the removed the following day.

Mr Cossey and Dr Bali will come to visit you on the ward and tell you how the operation went and what findings were made.  The nursing staff will be updated by Mr Cossey following your procedure and will keep him informed of your progress and any concerns during your stay.  Once you are settled and awake you will be offered refreshments on the ward by the nursing staff.

You will be seen by a physiotherapist who will teach you initial post operative exercises to help you move more confidently following surgery.  Should you experience any swelling or discomfort, gentle exercise will help ease these symptoms and aid your initial recovery phase.

How is my physiotherapy arranged ?

Julie Chaffey will arrange physiotherapy with your designated physiotherapist which is usually discussed prior to your surgery with Mr Cossey.  If you are planning to have your physiotherapy at the hospital an appointment will be sent to you automatically.  Mr Cossey will write to your physiotherapist on the day of your surgery and they will contact you to make an initial appointment.

When can I return to work ?

If you have had a knee arthroscopy you will be given a sick certificate for two weeks post surgery. Most patients are ready to return to work after two weeks (some before) but if you require a little longer your GP will be happy to provide a further certificate on request.

Patients undergoing reconstructive surgery, such as ACL repair, usually require between two to four weeks depending on the demands of your occupation.

Knee replacement surgery patients are usually away from work for a minimum of six weeks. Mr Cossey reviews all patients between two and six weeks post surgery, so will be able to advise at this point should you have any concerns about returning to work.  We are also more than happy to provide documentation outlining your knee condition should you require this for your employer.

When can I drive ?

If you have had a knee arthroscopy you are usually comfortable enough to drive any time during your second week following surgery. We advise that if you can perform an emergency stop with no discomfort then you are safe to drive.

More complex surgery such as knee replacement surgery  requires a longer recovery period. Six weeks is the minimum before starting to drive again.

Clerical Questions

Do we work within insurance companies fee schedules ?

Yes we work closely with all our insurers and adhere to their fee schedules  therefore our patients do not incur any ‘hidden charges’.  Should a shortfall occur for any reason the insurer should notify the customer in the first instance outlining their reason for not paying an account in full we will then liaise with you to collect payment accordingly within a reasonable timescale.

Do we provide sick certificates or letters to employers relating to our patient’s treatment ?

Yes certificates are supplied when leaving the hospital following surgery.  If you require additional documentation to support your leave of absence we are happy to provide this.

Are we able to provide letters for holiday companies and airlines informing them of your surgery ?

Following major surgery we can supply a letter for airport security and we are also happy to provide any information required should you need to cancel a holiday or change your seating on board an aircraft.

Do you supply all the information a patient needs for an admission to hospital ?

All information regarding admission to hospital is supplied directly from the Care Management Team at the hospital.  This information details the time of your admission and eating / drinking restrictions prior to surgery.  If you have any questions which are not covered in this information you are able to contact Julie Chaffey or the hospital directly.

Will I have access to advice from Mr Cossey if I need to contact him in between clinic appointments ?

Julie Chaffey is available to take your call and  receive emails 5 days a week. If your concerns are urgent you will receive a reply and advice the same day. All queries, questions and concerns are dealt with promptly as we understand the anxieties surrounding treatment and surgery.