Get Well Sooner! after a Hip or Knee replacement
Overnight stay or Same day discharge models or care
Whilst still major surgery with long recovery times, the progress in Hip and Knee replacement surgery in the last 10 years alone has been spectacular. Patients are up walking within hours and achieve functional recovery within weeks. Moreover, if appropriate, most patients at our clinic can have this done as overnight stay and in many cases, as day surgery too, going home in the evening after their surgery in the morning allowing them to rehabilitate in the comfort of their own home and with the support of their family and tailored allied health services.
Of course, a longer stay and inpatient rehabilitation facilities are still available for patients that require these services.
The underlying concept, Enhanced Recovery After Surgery (ERAS), is that of the making surgical experience a gentler one, leading to a quicker functional recovery… or GET WELL SOONER!
This methodology applies to not only the surgery, using the most minimally invasive surgical and anaesthetic techniques, but to all aspects of the patient’s surgical journey from the time of their initial consultation through to hospital stay and the back home:
Patient selection and education
Making sure that appropriate patients are selected and educated for this model of care to ensure success, whist maintaining safety and efficacy of the treatment. Patients who are medically well, motivated and have good family/ social supports are ideal candidates for this program, thereby allowing them to return home much sooner and recover in a familiar environment, with appropriate supports if needed.
Preoperative metabolic stress reducing agents
Modification to the anaesthetic regimen to minimise the common side effects of pain medications such as drowsiness and nausea.
This includes the use of a combination of local anaesthetic infiltration with synthetic opioids that have shown to reduce undesirable side effects whilst maintaining good pain control.
Pain Management Plan
The patient’s go home with the anaesthetist’s phone number and if there are any pain related issues, they can directly call.
Emphasising minimal trauma and maximal preservation also reduces the insult of surgery and, in turn, positively affects recovery. In hip replacements, SuperPATH is the least invasive and most preserving surgical technique when considering the soft tissue envelope. In knee replacements, various techniques and implant designs have claimed to make a difference. Our clinic is the most experienced in SuperPATH technique in the country.
Early mobilisation after surgery has a very positive influence on recovery as well as complication profile. Reduction of postop drowsiness and nausea allows early mobilisation. At our clinic, we aim to get ALL joint replacement patients up walking the same day as their surgery thereby giving them an early start on their functional recovery.
With an experience of over to 2000 joint replacements, our practice is well equipped and experienced in the ERAS methodology and minimally invasive techniques with a very low complication profile and excellent results as perceived by the patient.
Some of our publications in this field are referenced below:
Qurashi, S., Chinnappa, J., Aktas, S., Dabboussi, A.M. and Rahman, M.B. (2022), Overnight joint replacement surgery: a pilot Australian study. ANZ Journal of Surgery. https://doi.org/10.1111/ans.17977
Qurashi, S., Bajwa, S., Aktas, S., Bestic, W., & Chinnappa, J. (2021). Overnight or Short Stay Joint Replacements in the Public and Private settings: An Australian Experience. Reconstructive Review, 11(1). https://doi.org/10.15438/rr.11.1.283
Individual recovery patterns may vary and be influenced by various factors however, in most patients, short term recovery can be very quick. The following videos are aimed at giving patients an idea of what most people are like at different stages of recovery after their knee/ hip replacement.