Published on: 1 October 2019

Patients in South Tyneside are among the first in the country to return home within 12 hours of a total hip replacement.

 

Since December 2018, five patients have been able to leave South Tyneside District Hospital on the same day; five more are currently on the waiting list to do the same. Nationally, the average length of hospital stay following a hip replacement operation is between three and five days.

 

Suitable patients for the day case procedure arrive on the ward at South Tyneside District Hospital at around 7.45am. At 9.30am, the operation, lasting about 45 minutes to an hour, begins. By 1pm, they are walking with a physiotherapist and if, after a check x-ray and blood tests, it is considered safe for them to go home, then they can be discharged by 6.30pm. The outreach team, made up of an orthopaedic nurse and two technical instructors who provide physiotherapy and occupational therapy rehabilitation, follow up with a visit the next day and they stay in contact for up to two weeks to check on progress and pick up on any issues requiring the attention of Trauma and Orthopaedic Consultant Mr Jan Marciniak.

 

Mr Marciniak, who has been instrumental in introducing day case total hip replacement at South Tyneside, said: “There is a lot of evidence to show that patients recover better in their own home, where they feel happier and more comfortable. Also, for vulnerable patients, in particular, the shorter the stay in hospital then the less risk there is of them acquiring an infection. We are, therefore, delighted to be able to offer local patients this new service. A few centres elsewhere in the country have tried it but, without the benefit of quick check x-rays and an outreach team to provide support at home, usually the earliest they can discharge a patient is 23 hours.

 

“Our success is down to our joined-up approach with input from the pre-assessment and waiting list teams, radiology and anaesthetics colleagues, ward and theatres staff, physiotherapists and occupational therapists, and, of course, the outreach team.”

 

A total hip replacement is usually required due to wear and tear from arthritis. It improves quality of life by providing a long-term cure, with relief from pain. So far, the patients who have been able to take advantage of the new day case service at South Tyneside have been in their 50s and 60s but Mr Marciniak says age is not the crucial factor in determining suitable candidates.

 

“A healthy weight and being fit and well are more important than age,” he said. “The safety of our patients is always our main concern, which is why our rigorous pre-operative assessment is so important. That identifies whether a patient is suitable for day case surgery.”

 

Grandmother and retired company secretary Joan Jensen, of Whitburn, was the first patient to benefit from the new service in December last year. Mrs Jensen, who is now 70, said: “I was pleased to be given the operation before my mobility became even more restrictive. All the staff were very helpful and I’d like to say a special thank you to Mr Marciniak, and the outreach team in particular, for their wonderful care and support.

 

“I was very happy to be able to go home so soon afterwards without an overnight stay in hospital; it’s always nice to be in your own bed, in the comfort of your own home. Following the operation, I was grateful for the further support provided by staff of the physiotherapy department which I believe aided my speedy recovery and confidence in exercise. I hope when I have my second hip replacement it will be as a day patient again.”