Our Summary

The COVID-19 pandemic has forced healthcare systems around the world to make significant changes. This includes the way we perform elective surgeries, such as unicompartmental arthroplasty (a type of knee surgery). This study reviews the research on doing these surgeries as day-cases, where patients go home on the same day as the operation, rather than staying in the hospital.

The study reviewed 15 previous studies on day-case knee surgeries. They found that on average, about 4% of patients had complications and about 2.7% of patients had to be readmitted to the hospital. This is lower than the rates for patients who stayed in the hospital after surgery, which were about 6.5% for complications and 4.4% for readmissions. On average, about 92.5% of patients were successfully discharged on the same day as their surgery.

Based on these findings, the authors developed a plan for doing these surgeries as day-cases in a UK National Health Service institution. They emphasize that careful selection of patients and a well-defined plan for surgery and post-surgery care are crucial for success. This could improve patient care and make the healthcare system more efficient.

FAQs

  1. What is unicompartmental arthroplasty?
  2. What were the findings of the study on day-case knee surgeries conducted during the COVID-19 pandemic?
  3. How can day-case surgeries improve patient care and make the healthcare system more efficient?

Doctor’s Tip

A doctor might advise a patient undergoing knee replacement surgery to carefully follow their post-operative care plan, including physical therapy exercises, pain management, and wound care. It is important to communicate any concerns or complications to your healthcare provider promptly. Additionally, maintaining a healthy weight, staying active, and following a balanced diet can help support the healing process and long-term success of the knee replacement.

Suitable For

Patients who are typically recommended for knee replacement surgery include those with severe knee pain that limits daily activities, stiffness and swelling in the knee that does not improve with rest or medications, knee deformity, and failure to respond to other treatments such as physical therapy or medication.

In the context of day-case knee surgeries, patients who are relatively healthy, have good social support at home, and are motivated to participate in their post-operative care are good candidates for this approach. Patients with medical conditions that increase the risk of complications or those who have significant mobility issues may not be suitable for day-case knee surgery.

Overall, the decision to recommend knee replacement surgery, whether as a day-case or inpatient procedure, should be made on a case-by-case basis by the healthcare team in consultation with the patient. It is important to consider the individual’s overall health, medical history, and goals for surgery when making this decision.

Timeline

Before knee replacement surgery:

  • Patient experiences chronic knee pain, stiffness, and limited mobility
  • Patient undergoes pre-operative assessments, including physical exams, imaging tests, and blood work
  • Patient may undergo physical therapy to strengthen the knee muscles and improve range of motion
  • Patient discusses the surgery with their orthopedic surgeon and decides on the best course of treatment

After knee replacement surgery:

  • Patient undergoes the surgery, which involves replacing the damaged knee joint with a prosthetic implant
  • Patient stays in the hospital for a few days for monitoring and rehabilitation
  • Patient undergoes physical therapy to regain strength and mobility in the knee
  • Patient may experience some pain and swelling in the knee, which can be managed with medication and ice
  • Patient gradually resumes normal activities and follows a personalized rehabilitation plan to ensure a successful recovery

Overall, the goal of knee replacement surgery is to relieve pain, improve mobility, and enhance overall quality of life for the patient. With proper care and rehabilitation, most patients are able to return to their normal activities and enjoy a better quality of life after the surgery.

What to Ask Your Doctor

  1. Is unicompartmental arthroplasty a suitable option for me, or are there other alternatives that may be more appropriate?
  2. What are the potential risks and complications associated with knee replacement surgery, and how likely are they to occur?
  3. What is the typical recovery process like for patients undergoing knee replacement surgery, and what can I expect in terms of pain management and rehabilitation?
  4. Are there any specific criteria or factors that would make me a good candidate for a day-case knee replacement surgery, rather than staying in the hospital?
  5. How will my post-surgery care be managed if I choose to go home on the same day as the operation, and what support will be available to me during the recovery period?
  6. What is the success rate for day-case knee replacement surgeries compared to traditional inpatient procedures, and what are the potential benefits of choosing this option?
  7. How will my progress be monitored and what should I do if I experience any concerning symptoms or complications after the surgery?
  8. Are there any specific lifestyle changes or precautions I should take before and after the surgery to optimize my recovery and overall outcome?
  9. What is the expected timeline for returning to normal activities, such as work or exercise, following a day-case knee replacement surgery?
  10. Are there any additional resources or information available to help me better understand the procedure and make an informed decision about my treatment options?

Reference

Authors: Wignadasan W, Thompson JW, Ibrahim M, Kayani B, Magan A, Haddad FS. Journal: Ann R Coll Surg Engl. 2022 Mar;104(3):165-173. doi: 10.1308/rcsann.2021.0090. Epub 2021 Jul 29. PMID: 34323112