Overnight stay hip replacement is a reality at Spire Cardiff Hospital. Using slight modifications of traditional techniques instead of having to use new techniques requiring a learning curve or use of prostheses with limited track records, I have been working with the specialist physiotherapists and anaesthetists using enhanced recovery techniques to minimise bleeding, bruising and ultimately pain. We have been proving the concept for the last few months without forcing the issue. In other words, patients have not been pushed by us to be discharged the day after surgery which is getting common in North America, but have requested to do so because they have passed all the discharge milestones and have no pain. This is not suitable for all patients but if you are interested in this as a possibility please ask and myself and the team will do all we can to try and facilitate this for you. For instance it requires good support at home, reasonable muscle function before surgery, no significant medical problems. Knee replacements tend to be a little more painful afterwards so the minimum stay is usually 2 nights because of this but we have acheived it in smaller numbers of patients for knee replacement as well.
I have just analysed my results for the past year at Spire Hospital and the improvement in pain after hip and knee replacement is better than the UK average. All surgeons are expected to monitor and ultimately publish their results in 2017. The Oxford score is an established scoring system used nationally to report the level of pain and function in the hip or knee joint and can be used to monitor improvement after surgery. National databases show an average improvement of 16 points for a knee replacement and 21 points for a hip replacement. Not all patients can expect to see this improvement and it depends on the level of deterioration before surgery, as well as other factors such as multiple joint arthritis or poor mobility. click here for link
I have partnered with MyRecovery who are leading the field in smartphone or tablet apps to improve recovery and outcomes after surgery. If you are scheduled for hip or knee replacement you are able to sign up for access to a programme of short videos, patient information and exercises via your smartphone designed to guide you through the various stages before and after surgery to optimise your fitness and range of movement. Analysis of cases performed last year showed an even greater improvement in outcome scores to those described above for patients that used the app.