Alex Dodds explains why same day treatment shouldn’t be the goal, but same day mobilisation should.
*photo courtesy of Volodymyr Zakharov via Shutterstock
Recently, I performed my first private, same day partial knee replacement. If you’ve been researching your knee replacement options in Gloucester, Cheltenham and the Cotswolds, you may have come across the occasional story of patients who’ve had their knee replacement completed in a day and they’re home the same evening. Perhaps you feel that’s the sort of knee replacement you’d appreciate.
Well, for some patients it may be a possibility. But while same day surgery may be possible, I’d suggest it shouldn’t be the goal.
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Same day sense
Every patient is different. Most require a night or two in hospital post-surgery. Many of those who may not need the hospital stopover from a clinical perspective may wish it for confidence and reassurance, particularly if they live alone and/or have stairs to negotiate once they’re back home.
Even for my patient who went home same day, the quick turnaround wasn’t the goal of the exercise. I offered her a night or two if she felt she needed it. She just preferred to be at home. With her pain well managed, her confidence high and the procedure having gone well, there was no reason to decline.
The other element that was critical to the decision, and a far more reasonable aim than outpatient knee replacement, was same day mobilisation.
Why getting up and about matters
Mobilisation is simply movement. After knee replacement, we’ll usually get patients up and about, walking on their new knee (albeit with walking aids) the same day. This is important for a range of reasons.
It decreases the risks of blood clots in the leg. It reduces issues with pressure ulcers. It gets the joint moving, and there’s an element of psychological benefit too. If you’ve been out of your bed on day one and found movement relatively comfortable, you’re less worried about doing it again on day two, when everything is inevitably a bit stiffer and a bit more swollen.
Mobilisation sets patients on the road to a faster recovery, and it’s this we should be targeting. If they feel well enough to go home the same day once they’re up and about? Well, all well and good, but that shouldn’t be the goal.
Same day pressures
Same day knee replacement shouldn’t be the goal because we wouldn’t want to put patients in a position where they feel obliged or expected to be home by the end of the day.
Clearly, there are cost benefits for a private hospital that is able to send patients home on day one rather than days two or three. Those benefits are even greater for the NHS. But the starting point for NHS and private healthcare is that you get what you need.
If you need an extra day or two in hospital, you aren’t denied it or penalised for it. We wouldn’t want to be in a position where patients are asking for same day procedures just so they can cut the cost of their treatment.
Focusing on mobilisation
So for all the headlines about same day knee replacement surgery, my advice would be to look beyond that particular headline.
What really matters is mobilisation, because early mobilisation brings a range of benefits, one of which may be early discharge.
If you’d like to discuss your knee surgery in Cheltenham, Gloucester and the Cotswolds, please get in touch or call 01242 246549
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