Day Case & Short Stay Knee Replacement

Knee replacement surgery is the surgical treatment for knee arthritis, where the damaged knee is removed and replaced with an artificial knee implant. Traditionally, the procedure required a postoperative hospital stay of three to four days.

What is Day Case and Short Stay Knee Replacement?

Day Case and Short Stay Knee Replacement Surgery (also known as Outpatient Knee Replacement Surgery) utilise cutting-edge Rapid Recovery Protocols which involve advanced surgical techniques, less invasive methods, modern anaesthesia, and state-of-the-art post-operative pain management and rehabilitation. This allows patients to recover much faster and to go home in the first 24-48 hours after surgery.

Mr Sakis Pollalis utilises similar innovative RAPID RECOVERY PROTOCOLS to ALL his patients undergoing PARTIAL KNEE REPLACEMENT or TOTAL KNEE REPLACEMENT even to ones not planned for same day discharge. Therefore, all patients can mobilise a few hours after the operation and can be discharged within 1-2 days after surgery to recuperate in the comfort of their own homes. (Short Stay Knee Replacement).

Benefits of Recovering at Home After Surgery

Here are the 10 key advantages of recovering at home after knee replacement surgery:

1. Comfortable Environment: Being at home allows you to recover in a familiar, comfortable space, which can help reduce stress and promote better emotional well-being during the healing process.
2. Reduced Risk of Infection: Hospitals are environments where the risk of infection is higher due to the presence of multiple patients and invasive procedures. Recovering at home reduces exposure to hospital-acquired infections.
3. Personalised Care: At home, you can receive one-on-one care from family, caregivers, or home healthcare providers, ensuring that your specific needs are met in a personalized manner.
4. Convenience: Home recovery eliminates the need for additional transportation after discharge from the hospital and allows you to access your own amenities, such as your bed, bathroom, and kitchen, without needing to adjust to a different space.
5. Faster Recovery: Studies show that patients recovering at home may experience faster recovery times, as they can resume daily activities and regain independence sooner in a familiar setting.
6. Increased Mobility and Independence: Recovering at home encourages patients to move around within their home environment, which is important for regaining mobility and independence post-surgery.
7. Emotional Support: Being around loved ones can provide emotional support, which can be very beneficial for morale and mental health during recovery.
8. Tailored Physical Therapy: You may have a home physical therapist who can tailor exercises to your home environment, ensuring that the therapy is practical and directly relevant to the spaces you move in daily.
9. Improved Sleep: Being in your own bed and controlling your sleep environment can lead to better quality rest, which is essential for healing after surgery.
10. Control Over Daily Routine: Recovering at home allows you to control your schedule, including meal times, rest periods, and physical therapy sessions, making it easier to manage your recovery in a way that suits you.

When is Day Case Knee Replacement suggested

Day Case Knee Replacement surgery is typically suggested for patients who are healthy enough to recover safely outside of a hospital setting and meet specific criteria. Advances in RAPID RECOVERY PROTOCOLS have made Day Case joint replacements more common. Here are the conditions when outpatient joint replacement surgery is often recommended:

1. Good Overall Health: Patients should have no significant underlying health conditions (e.g., heart disease, uncontrolled diabetes) that could complicate anaesthesia or recovery. A strong general health profile is crucial for a smooth outpatient procedure.
2. Minimal Surgical Complexity: The joint replacement surgery should be straightforward, with minimal anticipated complications, bleeding, or extended recovery time. Candidates should not require intensive post-operative monitoring.
3. Strong Support System at Home: Patients need a reliable support system, including family members or caregivers, who can assist with mobility, post-op care, and transportation immediately after surgery.
4. Healthy Weight: A BMI within a healthy range reduces the risk of complications during surgery and ensures a faster, smoother recovery. Higher BMIs can increase the risk of post-op issues, making outpatient surgery less viable.
5. Motivated and Independent: Patients must be highly motivated to follow through with rehabilitation, physical therapy, and home care instructions. They should also have enough mobility and independence to perform basic self-care tasks soon after surgery.

What to expect from Day Case or Short Stay Knee Replacement

Before the Procedure:

Before surgery, you will have a pre-operative evaluation, including a physical exam, imaging, blood tests, and a review of your medical history. On the day of the procedure, you’ll arrive at the hospital’s ward and be prepped for surgery by the nursing team. You will meet Mr Sakis Pollalis and his anaesthetist and you will discuss your personalised surgical and anaesthetic plan.

During the Procedure:

• The surgery typically lasts about 1 hour. It is performed under regional (spinal) or general anaesthesia using a tailored RAPID RECOVERY PROTOCOLS to ensure you are comfortable and pain-free during the procedure.
• A tourniquet is applied to your upper thigh to reduce blood loss but will only used for a short period of time to avoid discomfort postoperatively.
• Mr Sakis Pollalis will make a small, minimally invasive incision at the front of your knee which measures usually around 4 to 5 inches (compared to 10 to 12 inches for traditional surgery), ensuring that the surrounding muscles and tendons are split but not cut. This facilitates faster recovery.
• The damaged portions of the femur (thighbone) and the tibia (shinbone) and sometimes the patella (kneecap) are trimmed at appropriate angles using specialised jigs and special guides to ensure a perfect fit of the implant and good balancing of the soft tissues.
• Trial components are then used to test the knee joint for range of motion and soft tissue balancing. Following this, the final implants are attached to the end of the bones with bone cement. A polyethene (plastic) liner is then placed to act as an articular surface between the thighbone, shin implants and the back of the kneecap (if required) to ensure smooth gliding movement.
• The knee is then rejoined and washed, and the surrounding tissues are brought back to the normal position using absorbable sutures. As the incision is very small, fewer muscles and tendons are traumatised. 

After the Procedure:

Immediately following surgery, you will be taken to a recovery area where your pain levels will be monitored, and you will be encouraged to begin moving your knee. You will soon be moved to the ward where you will be assisted to get dressed and you will be offered a meal. You will be given pain medications to ease pain. Whilst in hospital you will have to wear stockings to prevent blood clots in your legs. Physical therapists will work with you to take your first steps using a walker or crutches. You will have blood tests and an x-ray to check the positioning of the implants. Mr Sakis Pollalis will review you regularly whilst in hospital and after your discharge to make sure you are progressing well.

Recovery at Home:

Once cleared by the medical, nursing, and physiotherapy teams, you will be discharged to recover at home. Early movement is encouraged to promote healing and prevent complications. You will receive detailed instructions, such as:

• Use of assistive devices for walking, such as cane or crutches
• Adherence to prescribed medications for managing pain.
• Suture and dressing care.
• Physical therapy and exercise regimen to improve range of motion and strength of muscles.
• Follow-up appointments to monitor your progress.

Risks and Complications of Same-Day Knee Replacement

Complications are very rare and minimised with an experienced surgeon. While the risks may not be higher than traditional inpatient surgery, it's important to be aware of the specific complications that could arise in a same-day setting:

• Infection
• Blood Clots (Deep Vein Thrombosis or Pulmonary Embolism)
• Stiffness or Limited Mobility
• Pain Management Issues
• Dislocation or Instability
• Nerve or Blood Vessel Injury
• Bleeding and Hematoma
• Difficulty with Recovery at Home
• Fractures
• Prosthesis Failure or Loosening
• Revision surgery
• Cardiovascular Events
• Hospital Readmission
• Delayed Recognition of Complications