Return to action: how enhanced recovery after surgery works

Written by: Mr Rishi Chana
Edited by: Nicholas Howley

How long does it take to recover from hip or knee surgery? In the past, a three month recovery from hip surgery was normal. But thanks to the introduction of enhanced recovery programmes at select clinics around the UK, you can enjoy a recovery that takes half the time and involves minimal pain. We asked leading orthopaedic surgeon Mr Rishi Chana how an enhanced recovery programme works and what patients can expect.

What is enhanced recovery after surgery?

The idea of enhanced recovery came from getting you back into your ‘normal’ routine as soon as possible.

Historically, knee and hip replacements took months to get over and patients stayed in hospital for several weeks. Some even had a plaster cast!

Surgery and anaesthetic techniques are now so advanced that the joint operated on is totally stable and able to function in a normal way pretty much as you come off the operating table. This means that you can get back to normal as soon as the rest of your body recovers – after the muscles recover from bruising and your head gets over the anaesthetic.

This typically means:

  • after 12 hours you are ready to take your first steps on your new hip / knee
  • after 2-3 days you can return to the comfort of your own home
  • after two weeks, you will have a follow-up appointment to do a wound check, remove the sutures/clips, and monitor your progress.

The orthopaedic surgeon who carried out your operation is generally on call if there are any problems. In my clinic, the physiotherapists who look after you can call me any time, and I am directly reachable via a 24-hour emergency hotline.

What does enhanced recovery involve?

Enhanced recovery is a multiple-faceted approach to getting you better. The idea is to ensure you are prepared enough before and after surgery to safely return home with confidence and pain-free function. The physiotherapists, nursing staff and your surgeon will tailor your surgery plan to suit your individual needs and requirements.

Why have enhanced recovery after a total knee replacement?

The knee is the largest joint in the body. This means that there is a big area for scar tissue to form which can get in the way of movement.

Think of a dirty windscreen and its wipers. In the case of the knee, the “wipers” clear away the scar tissue to allow for a range of movement. If the wipers only clear a small area then the movement is very stiff and restricted.

That is why we strongly encourage maximum movement as soon as possible to ensure a great outcome. With enhanced recovery you will have plenty of painkillers and support to get this movement going!

Why have enhanced recovery after a hip replacement?

Hip replacements are very successful and most patients at six weeks feel very confident and happy with their new hip.

Enhanced recovery for hip replacement means you get up the very next day and walk on it – your first steps to pain free movement! Hospital stays are usually only 2-3 days. You may have some pain from a buttock bruise for a couple of weeks, but this is something that paracetamol and simple painkillers can help with. Most people use these for two or three weeks.

What does enhanced recovery after a hip arthroscopy look like?

Hip arthroscopy or keyhole surgery traditionally required a three month recovery. The first phase was 6 weeks with crutches and pain was always an issue. In our clinic, I have worked extensively on developing a new enhanced recovery protocol specific to hip arthroscopy to halve this time with pain-free to mild-discomfort recovery. I am now able to offer recovery from this important joint saving operation after only two weeks.

If you would like to book a consultation with Mr Rishi Chana regarding hip or knee surgery, click here .

By Mr Rishi Chana
Orthopaedic surgery

Mr Rishi Chana is a skilled consultant trauma and orthopaedic surgeon based in London and the surrounding area. He specialises in lower limb surgery - particularly surgery of the hip and knee. He is an expert in performing arthroscopy of both the hip and knee, joint preservation surgery, hip and knee replacements, and is a certified to perform the world's most accurate hip and knee surgery.

A graduate of the Royal Free Hospital Medical School (University of London,1999), Mr Chana is now a Fellow of the Royal College of Surgeons (Trauma and Orthopaedics) (FRCS Tr&Orth). He is fellowship-trained in hip arthroscopy and completed a world-renowned fellowship in Sydney, which trained him to deliver an exceptionally high quality joint replacement service with enhanced rehabilitation. Mr Chana served as Lower Limb Lead for Ashford & St Peters Hospital in 2017, and presently practises at a number of locations, including Spire Thames Valley HospitalSchoen Clinic, London, and a number of BMI hospitals. He is also part of the Surrey Orthopaedic Clinic.

Mr Chana has a wide range of expertise, being able to treat adult patients both young and old with hip, groin and pelvic pain. His patients include athletes suffering from conditions such as labral tears and pincer impingment, and has a track record of returning them to action. He emphasises patient care and, as a result, achieves a high level of patient satisfaction.

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