Day case total hip replacement: Expert insight on what’s involved

Written by: Mr Senthil Kumar Velayudham
Published:
Edited by: Sophie Kennedy

A new milestone in orthopaedic surgery, day case procedures are now a real option for some patients requiring total hip replacement. In this informative article, revered consultant orthopaedic surgeon Mr Senthil Kumar Velayudham shares his expert insight on how patients are prepared for day case total hip replacement surgery by a multi-disciplinary team of specialists and reveals how patients are helped to manage their journey to recovery in the comfort of their own home.

What is day case total hip replacement?

Day case total hip replacement is a significant advancement in patient care, allowing patients to go home on the same day as their surgery. It's part of an enhanced recovery program designed to speed up healing after total hip replacement, improve patient satisfaction, and reduce complications like deep vein thrombosis (DVT).


How are patients prepared for their operation?

This approach highlights the power of teamwork among various healthcare professionals to ensure the best possible outcomes for patients. Our team, including nurses, physiotherapists, occupational therapists, anaesthesiologists, and surgeons, collaborates to prepare patients thoroughly for their procedure. This means that patients receive clear information about pre-surgery preparations, anaesthesia, minimally invasive surgery, recovery timelines, and symptom management.

A comprehensive assessment ensures patients are suitable for day case hip replacement, helping patients to feel confident about their treatment journey and setting expectations of what types of results they can benefit from. In addition, our advanced anaesthesia techniques ensure patients are pain-free during and after surgery, allowing quick recovery and early mobility with our specialised physiotherapy team.


What is the recovery process like following day case total hip replacement?

Minimally invasive hip replacement techniques preserve muscle function, reduce blood loss, and lower the risk of post-surgery issues like haematoma. These approaches, combined with precise hip anatomy restoration and secure implant fixation, enable patients to start moving early and safely, guided by our physiotherapy and nursing teams.

Before discharge, each patient receives a personalised recovery plan, including exercises and pain management, tailored by our ward team. Patients are only discharged when it's medically safe and the patient feels confident about starting their recovery journey at home.

Upon discharge, patients receive guidance on managing symptoms and our contact information for any concerns or questions. Although rare, complications can occur but with post-discharge management, patients can be confident that any issues will be detected quickly so that effective interventions can be put in place.


Can all patients who require a total hip replacement undergo day case surgery?

It's important to note that day case total hip replacement isn't suitable for everyone, and only a relatively small number of patients qualify. Some planned day case surgeries may need adjustments due to factors like anaesthesia recovery, minor complications, or social considerations.

Patient eligibility also depends on factors like the complexity of the hip replacement, underlying health issues, physical fitness, and social support. However, our enhanced recovery program has been proven to increase patient satisfaction and reduce hospital stays.

Twenty years ago, patients typically spent ten days in the hospital after hip replacement surgery. We've reduced this to just 1–2 days for most patients, placing us in the top two per cent in the UK. We're proud to continue developing this approach and offering many patients day case total hip replacement.

Looking forward, there's potential for further progress, with total hip replacement mirroring some hand surgery procedures where patients go home directly from the recovery unit. It's an exciting time for hip specialists dedicated to improving patient care in hip replacement surgery.




If you require hip replacement surgery and wish to discuss your suitability for a day case procedure, you can schedule a consultation with Mr Velayudham by visiting his Top Doctors profile.

By Mr Senthil Kumar Velayudham
Orthopaedic surgery

Mr Senthil Kumar Velayudham is a highly esteemed consultant orthopaedic surgeon specialising in hip surgery based in Tunbridge Wells, Kent. He was appointed as consultant orthopaedic surgeon at Maidstone and Tunbridge Wells Hospital in 2006. He also practices at Nuffield Health Tunbridge Wells and Horder Centre, Crowborough, East Sussex.

His special interest includes the treatment of hip arthritis.  He performs high volume minimally invasive hip replacements using techniques that minimise blood loss and allow enhanced recovery. He uses well established high performing prostheses and has excellent long-term results and patient satisfaction as confirmed on National Joint Registry data. Other subspecialty interests include hip impingement, painful hip replacement, failed total hip replacement, hip labral pathology, young adult hip problems, robotics or computer-assisted surgery etc. Commonly performed procedures include revision hip replacement, complex hip replacement, resurfacing hip replacement, custom made hip replacement, robotic hip replacement, hip arthroscopy etc.

Mr Velayudham completed his initial medical studies in India, his medical degree at the University of Chennai in 1990 and his postgraduate study in trauma and orthopaedics at the University of Pune. Soon after, he relocated to the UK and completed further higher surgical training in trauma and orthopaedics at various hospitals including Guy’s and St Thomas' Hospital. In addition, he undertook a fellowship in pelvic and acetabular reconstructive surgery at St George’s Hospital and another in hip reconstructive surgery at the Royal National Orthopaedic Hospital. He is trained in using the latest surgical techniques including computer navigated surgery and robotic hip replacement surgery. Mr Velayudham is clinical governance lead in trauma and orthopaedics for Maidstone and Tunbridge Wells NHS Trust. He chairs the monthly multidisciplinary complex hip and knee meeting and also is a faculty member of the Royal College of London’s training program for trainees in trauma and orthopaedics.

Mr Velayudham’s research interests include bone remodelling around hip prostheses, optimizing hip replacement alignment and bone grafting for acetabular defects. To hear insight from patients treated by Mr Velayudham on their experience, please read the following articles, including on hip replacement surgery and the associated enhanced recovery programme.

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