Day Case Joint Surgery

Day case surgery is an operation or surgical procedure that does not require an overnight stay in the hospital. A patient is admitted and discharged on the same day. They normally go home a few hours after the procedure. Day case surgeries have increased over recent years as more operations are performed by keyhole surgery and anaesthesia has advanced.

Day case joint replacement operations include minimally invasive surgeries to replace the main joints of your body. Nowadays, hip, knee, shoulder, elbow, wrist and ankle replacements are available as day case joint replacement surgery.

There are a number of benefits of a day case surgery that includes:

• Reduced length of stay in hospital
• Faster and simpler recovery so patients can get back to their daily life quicker
• Smaller scars as only small cuts are required for keyhole surgery
• Reduced costs
• Patients can often arrive at the hospital closer to their operation time
• Earlier mobilisation
• Reduced pain as less invasive
• Lower hospital-acquired infection rates and blood clots
• Increased patient satisfaction

It is important to prepare and plan ahead for the physical and psychological aspects of joint replacement surgery to help ensure you have the best outcome. Here are some preparation tips for your surgery:

• Find out all about your day case procedure including what to expect before, during, and after surgery. You might ask what anaesthetic you will have, what prosthesis will be used, how long your recovery will take.
• Put together a list of your personal and medical information, as you will be asked these questions many times. You should include family or friend and GP contact details, your insurance policy information, and any medical conditions or health problems you have including previous operations, medications you regularly take, allergies and dietary restrictions.
• Get your body as healthy as possible to lessen the chance of complications and shorten your recovery time. This includes quitting smoking, eating a nutritious diet, losing weight if needed and doing pre-op exercises to strengthen your body.
• Prepare for your return home. Take steps to ensure your comfort and safety once home. These might include: batch cooking, inviting a friend or family member to stay with you for a few days after surgery, placing frequently-used items within easy reach, shopping for items that will make your life easier after surgery such as a grabber, rearranging furniture so you can easily manoeuvre with a cane, walker, or crutches, and removing any rugs or slip hazards.
• Get ready for your day of surgery. Pack what you want to take including a loose-fitting outfit and comfortable shoes to wear home. Shower before your surgery. Do not wear make-up, jewellery or nail polish. Follow your pre-surgery instructions for eating, drinking and medications.

Your post-operative recovery process after a day case surgery will depend on your exact surgery and your individual health and fitness. Your Ramsay hospital team will give you specific advice for you to follow.

You can expect to walk on the same day as your operation. If you have had a knee replacement, you will be encouraged to walk with a frame or crutches. You can expect to feel discomfort while walking and your legs and feet may be swollen. Most people are able to walk independently with sticks after about a week. You will gradually need your stick less and less.

Whilst in hospital, a physiotherapist will show you exercises to help strengthen your hip or knee. They will also talk you through what you should and should not do after your operation. These exercises are an important part of your healing process and can help you to recover sooner.

Initially, you may feel tired as your body starts to heal.

You might have some post-operative pain and you may be given pain relief before leaving the hospital.

Keep in mind that everyone recovers differently. You can expect to return to light activities or office-based work after around six to twelve weeks depending on your job type and day-case surgery.

We will arrange a follow-up appointment around two weeks to check on your recovery progress and offer any further exercise advice. For hip replacement surgery we will typically see you again at six weeks after your surgery and for knee surgery we will continue to invite you back until we think you can rehab independently.

You can resume driving after about six weeks, once your surgeon gives the ok. If you have had knee surgery you will need to be able to bend your knee enough to get in and out of a car and control the car properly.

It is important to do daily exercises to help your recovery. It will take time to build up your strength and this requires regular exercise. You will notice a change within weeks but you will need to allow time to regain your full fitness. Your physiotherapist will advise you on the frequency and repetition of exercises to achieve your own personal goals.

For your joint exercise session all you will need a chair and a resistance band.

Each time you exercise you should start with a good warm-up routine. Warm-up exercises can include marching, shoulder shrug, wider stance kick heels, knee lifts, heel digs, sideways steps, backwards steps, arm lifts, and triceps, pectorals, rhomboids, calf, hamstring and adductor stretches.

Your main exercise plan after knee and hip day case surgery can include:

• Chair exercises
• Sitting: knee bends, knee extension, leg press pushing against a resistance band
• Sitting to stand
• Standing: hip abduction, hip extension, hamstring curls, mini squats, heel raises, lunges, hip flexion
• Walking with sticks
• Bed exercises: foot pumps, static quads, knee extension, straight leg raise, knee bends and hip abduction.
• Knee exercises: ankle pumps, static quads, bottom squeezes and gentle knee bends.
• Standing exercises: side bends, marching on the spot with lower or higher legs depending on what you are able to do, hip abduction, upright row using resistance band on feet, wall press, mini squats, half jacks from a standing position
• Make sure you spend time cooling down too, by incorporating a gentle march, stretches for your triceps, pectorals, rhomboids, calves, hamstrings, hip adductors and hip flexors, and side bends.