Day Case Hip & Knee
Replacement Surgery

Day Case Hip & Knee Replacement Surgery

What is day case joint replacement surgery?

Day case surgery, (also known as ’23 hour’ or ‘one day surgery’) is now a routine way to undergo joint replacement surgery.

In essence, you come into hospital, you have your hip or knee replacement operation, and you leave hospital to return to the comfort of your own home, all within the same day.

The number of days that people stay in hospital after joint replacement surgery has been reducing year-on-year. Day case surgery came about as a natural progression of better techniques and a desire to get patients up and active soon after surgery.

What are the benefits of day case joint replacement surgery?

It’s well documented that the longer you stay in hospital after surgery, the more chance you have of developing a complication.

When we’re in hospital, there’s an increased risk of infection, and our risk of blood clots goes up if we’re not mobile. Being in hospital can be stressful, and research has shown that when we we’re in our home environment, our pain levels are reduced. We also eat and sleep better and of course, we’re close to our families. This all helps with recovery.

Within an hour of the surgery and with the assistance of a physiotherapist, you’ll be up and walking. This is great for the early recovery of the hip and knee muscles, but it’s also good news for circulation and breathing.

If you’re offered day case surgery, you’ll be pleased to know there is no increase in complications with going home on the same day, and my patients tell me they were very pleased to be able to get home so swiftly.

Who is suitable for day case surgery?

To be suitable for day case surgery, you need to be in good all-round health. If you have a history of heart disease, lung problems, diabetes, other chronic medical conditions, or if you are taking blood thinners or steroid medication, you’re unlikely to be suitable for day case surgery.

It’s important that you have good support from family and friends when you arrive home from hospital and your home needs to be a safe environment in which you can move around freely. To be considered for a day case operation, you’ll also need to have a good level of mobility prior to surgery.

Smart sensors 

I have started using smart wearable sensors to help provide my patients with individualised rehabilitation after their hip or knee replacements. This can often enable my patients to go home on the same day of surgery. These sensors help patients prepare beforehand for their surgery by doing a series of exercises to help strengthen their muscles which can help them recover quicker and better after surgery.

What happens on the day of the surgery?

You’ll be well-prepared by the time the day of surgery arrives.

3 to 4 weeks in advance of the operation, we’ll have a pre-op consultation, and I’ll explain to you exactly what’s going to happen, what you can expect around the time of surgery, medications that you’re going to be on afterwards, and how you need to prepare yourself for surgery in terms of physiotherapy exercises.

You’ll receive a booklet, which I’ll ask you to read carefully, so that when we go through the consent to surgery process, you’ll be fully informed. You’ll also be assessed by our anaesthetist

On the day of surgery, you’ll come into hospital fasted. You’ll meet with myself and the anaesthetist, and we’ll confirm you’re well and are happy to proceed. I’ll also mark the hip or knee that’s going to be replaced with an indelible pen, and we’ll bring you to the anaesthetic room.

The anaesthetist will administer short-acting spinal anaesthesia and that means that your leg will be numbed for a few hours, and there will no pain during the surgery.

In the operating theatre, music can be very relaxing, and you may wish to bring some headphones and a portable music player. Sometimes a light sedation may be needed, but most people don’t require this.

The surgery takes around an hour, then we’ll meet again the recovery area. After a short while, you’ll return to the ward, have something to eat and drink, and within an hour, you’ll be up and walking with the physiotherapist.

You’ll receive medication to effectively manage any pain, so you’ll be comfortable when you arrive home at the end of the day

The wound will be covered with a sterile dressing and it’s important that you don’t disturb it, and it stays on until we meet again in clinic, which is two weeks later. The surgical incision is closed with a stitch that runs underneath the skin; there are no stitches or clips to be removed. I also use a skin glue to help reduce the risk of wound bleeding. The dressing is waterproof, so you can take a shower, but you should avoid soaking in a bath.

Will I be safe to go home on the same day?

Our goal is to enable you to get home to the comfort of your own surroundings on the same day. If for any reason, you don’t feel ready or able, it’s perfectly OK for you to stay in hospital overnight.

Once you’ve been assessed by the physiotherapist (and you can use your crutches and go up and down stairs safely), and provided you’ve been able to pass urine and are feeling well, we will start the process of getting you home.

You’ll have an X-ray and a blood test to confirm that everything’s going well, and when we’re happy your pain is well controlled and the wound has remained dry, you can expect to get home in the early evening.

Around 10pm the same night, you’ll get a call from the ward to check on how you’re doing, and again the following morning.

When you’re in hospital you’ll be given exercises to carry out at home by the physiotherapist, and you may wish to see your own physio locally.

Two weeks after the surgery, we’ll meet again in the outpatient clinic, and I’ll remove the dressing.

The vast majority of patients who have day case surgery, don’t need to be readmitted to hospital once they’ve left. If for any reason you were to feel unwell, (e.g. if you felt faint or dizzy, or if your pain wasn’t sufficiently well controlled), we would immediately assess you.

Patients who undergo day case surgery are usually delighted with the experience, and progress very well after surgery.

If you’re considering a hip or knee replacement surgery, why not book a consultation to discuss if day case surgery is a suitable option for you?