Day case hip replacement surgery: A complete guide

In his latest online article, renowned consultant orthopaedic surgeon Mr Manju Ramappa offers his expert advice on day case hip replacement surgery. This is a complex procedure, that only a few surgeons in the UK offer. Mr Ramappa explains the criteria for a day case hip replacement, what happens on the day of the procedure and what the recovery process looks like.

What are the criteria for being eligible for day case hip replacement?

All patients are suitable for day case hip replacement, as long they are mobile before surgery and live with someone at home. When I started doing day case hip replacements in August 2021, the inclusion criteria were strict. Over time, I have expanded the inclusion criteria so that more patients can benefit from day case hip replacement surgery.

What will happen on the day of my surgery?

Pre-surgery:

You will be admitted to the ward a few hours before surgery on the day of surgery. There will be some checks done by the nursing and medical staff. You will be reviewed by the anaesthetic and orthopaedic teams.

Surgery:

Usually, spinal anaesthesia is used unless there are any contraindications. From experience, patients are more comfortable post-surgery with this type of anaesthesia. Depending on your preferences, you can choose to be awake or sedated during the procedure. You can listen to music if you prefer during surgery.

Post-surgery:

Following the surgery, you will go to the ward. You can eat and drink immediately upon return to the ward. One of the big advantages of spinal anaesthesia is that the effect of the anaesthesia will last longer than the surgery. Thus, the numbness and comfort in your leg will last longer than the actual procedure. Additionally, before the pain worsens, you can take another dose of painkillers. The goal is to obtain pain relief following surgery before the discomfort gets severe.  

Once the effect of the anaesthesia has completely worn out, you will be mobilised on the same day of surgery. You will be reviewed by the physiotherapist on the same day. This very much depends on what time of the day, the anaesthesia effect wears out. The physiotherapist will also teach some hip exercises to be performed at home.

You will have blood tests and X-rays performed on the same day of surgery.  You will have to pass all the checks before being deemed fit for discharge. If we believe that you need more time in the hospital before being discharged, we will keep you in the hospital overnight. Your safety is our priority.

Interestingly, patients find the pain is less when they start mobilising.   

There are 3 goals with this pathway:

1. Provide good pain relief

2. Mobilise early

3. Promote early recovery

What are the long-term outcomes of day case hip replacement?

The long-term outcomes of a day case hip replacement are similar to standard hip replacement. The main advantage of day case hip replacement is it provides all the advantages of day case surgery such as early mobilisation, early recovery, reduced risk of clots, and reduced risk of infection. It also improves patient and staff motivation as they are involved in every step of the protocol and recovery. Patients play an active role in this pathway. It is very much patient-driven.

Hence, there are significant advantages to day case surgery.

If you would like to book a consultation with Mr Ramappa, you can do so today via his Top Doctors profile