Fast Track knee replacement reduces stay and recovery time | News

A 68-year-old man has become one of the first patients in Surrey to go home from hospital the day after he underwent a knee replacement.

Graham Lee was on his feet just hours after major surgery to replace his joint thanks to a new fast track procedure introduced at Royal Surrey County Hospital NHS Foundation Trust.

On average patients normally spend four to five days in hospital after undergoing a knee or hip replacement.

Thanks to Orthopaedic Surgeon Kate Gill’s fast track procedure they are now being discharged from hospital and sent home after 24-36 hours.

Mr Lee said: “I faced the operation with trepidation and was very worried but she’s done a fantastic job.

“I could not believe that I had to get up the same day I had the operation, or indeed that I was actually able to get up and walk around. The following day I was able to go home.

“The progress since then has been remarkable, after the first few days I hardly used the crutch at all and enjoyed a very active day trip to France five weeks later.”

Miss Gill’s Fast Track procedure shortens recovery by using a local anaesthetic in the spine in combination with sedation, which does not leave patients feeling sick or nauseous. At the end of the process a local anaesthetic mixture is injected into the tissues around the knee.

As a result they are able to get mobile far sooner and ultimately back to full health. This process reduces the risk of strokes, heart attacks and blood clots.

Miss Gill said: “The surgery itself is one of the only bits of the fast track process which has not changed.

“I use the same procedure and the same implants to replace the worn out knee or hip.

“Prior to the operation patients are given carbohydrate loading drinks and allowed to drink water until two hours before surgery, which supports a quicker return of bowel function, less loss of muscle mass and faster recovery.

“The patients walk themselves to theatre and before and during the operation they are kept warm to reduce the risk of infection and blood clotting issues.

“In recovery patients are given a high calorie drink and once back on the ward they get dressed in their own clothes as soon as possible, which helps them get ready to meet the physiotherapy team.”

Katie Grimshaw, Chartered Physiotherapist specialising in Trauma and Orthopaedics, saw Mr Lee within hours of his operation to support his mobility and to make sure that he was able to perform basic tasks well enough to go home.

“For the Physiotherapy Team, the fast track pathway has meant that our patients feel well after their surgery and anaesthetic, and are ready to get dressed, get out of bed and exercise within hours of their surgery,” she said.

“The core physiotherapy treatment given to patients has not changed, but the speed with which our patients meet their goals for post-operative rehabilitation is much faster.

“This improvement carries on through to the next day and our patients continue to feel well and have their pain under control.

“Fast track patients meet the discharge criteria sooner and they are therefore able to go home safely the day after their surgery.”

Patients with complex medical problems will not be able to leave hospital as quickly, but will still benefit from being mobile much quicker.

Miss Gill added: “We reassure all our patients that they will not be pushed out of hospital if they are not ready.

“Patients are understandably initially apprehensive about getting up so quickly after surgery, but once they realise that this helps reduce their pain they are happy to walk a short distance at regular intervals.”

Since leaving hospital, Mr Lee has continued physiotherapy and has enjoyed getting back to gardening which he had been unable to do.

Mr Lee said: “You have to put the effort in and do the exercises, but the physiotherapists have been fantastic.

“A lot of people fear this operation. I nearly postponed it, but now I wish I’d had it done earlier.

“Miss Gill has done a fantastic job. She’s my hero, I can’t praise her enough. Everyone at Royal Surrey has been fantastic, it’s a real team effort.

“I want to get my other knee done and be able to get my bike cleaned up and ride with my grandson.”