London hospital pioneers new approach to hip and knee surgery

Patient Cheng Ong (second from front left) alongside staff who treated her at Chase Farm Hospital (Royal Free London NHS Trust)
Patient Cheng Ong (second from front left) alongside staff who treated her at Chase Farm Hospital (Royal Free London NHS Trust)

A London hospital has pioneered a new approach to orthopaedic surgery that allows patients to go home on the same day of their hip and knee replacement surgery.

Patients at Chase Farm Hospital in Enfield were able to go home just hours after their surgery ended.

Experts say that treating knee and hip replacements as day cases means fewer complications like blood clots and aids recovery by encouraging patients to get moving sooner.

Rather than a general anaesthetic, many of the patients prefer a spinal aesthetic, sedation and regional anaesthesia to help with early mobilisation. This means they are well enough to go home on the same day of treatment.

Clinicians complete all the necessary therapy after the operation is complete, ensuring they can get in and out of bed, up and down stairs and go to the toilet.

Paddy Subramanian, consultant orthopaedic surgeon at the hospital, said: “Patients love it. We had a lady in recently who had the operation on Friday and told us she was in her garden and the hairdressers the following day.

“It’s a change in mindset for patients and staff that these are not sick nor unwell patients and they are coming in for a joint replacement procedure analogous to a tyre change rather than a complete new engine.”

Ursula Knight, an advanced nurse practitioner in elective orthopaedics, said patients recovered better in their own homes because they often have to walk more to reach their bathroom or the TV. This in turn helps reduce the risk of complications.

Before being discharged, clinicians check their vital signs and take an X-ray.

Patients are sent home with the same level of pain manavement as they would receive if they stayed in hospital and receive a follow-up call within 24 hours after discharge.

“Patients tell us nothing beats waking up in your own bed,” Ms Knight added.

Cheng Ong, 62, from Borehamwood, was able to go home within hours of having his knee replacement and praised the “fantastic” team that treated him.

She said: “When I had my pre-op consultation I was told I was a good candidate to go home the same day. I was shocked and queried it but they reassured me and I really liked the idea. I had the first operation on my right knee towards the end of August and as soon as I got to the ward afterwards the therapist did all the tests to make sure I was ready to go home.

“Armed with my pain medication and my exercises I felt ready to go and my daughter collected me after she finished work.”

Cheng said the operation went so well that she had her second knee operation at the end of October.

She added: “I’d had to give up work a while ago because I couldn’t walk and was in a lot of pain but now I’m planning a trip back to Singapore to see family and am thinking about looking for part-time work when I come back. I was determined to help myself so I followed all the instructions and the team were absolutely fantastic.”