The average length of stay following hip or knee replacement is 3 to 4 days. Across the globe, day-case replacements are routinely performed – yes you get to go home the evening of your surgery! Usually a wealth of resources are available for this to occur such as home nursing and physiotherapy visits and currently this is not a service that we routinely provide.
However, it is possible for committed and determined patients to aim for discharge two or even one day following their surgery. Remember, whilst a wish to do this is admirable, the most important thing is that you go home when safe to do so and that your overall safety or recovery is not compromised.
The advantages are that patients often feel much more at ease in the comfort of their own home. They are usually able to sleep much better in their own bed.
Who are ideal candidates?
Patients living relatively close to the hospital
Patients with few if any co-morbidities.
Younger patients
Patients who have some-one at home with them to provide some assistance in the first few days.
Tips
Read as much as you can about your surgery and recovery prior to the surgery so that you can hit the ground running.
Bring your own clothes and get back into them as soon as you can after surgery so that you feel more human and less of a patient.
Talk to your family so that some support is available.
Think about the home environment prior to surgery. Easy access to toilets, a walk in shower and downstairs bedroom are all ideal but not available in every household. Simple changes such as moving your bed downstairs may be an option or staying with a close friend or relative may even be considered. You will be able to safely ascend and descend the stairs prior to your discharge but if you can keep this to a minimum then all the better.
Try to avoid having pets running around
Beware of rugs and loose carpets. The last thing you need is a slip early in the course of your rehab and the risk of sustaining a fracture involving your new joint.
Think about meals. A few pre cooked meals in the freezer can make life a lot easier for you in the first few days. Try to get plenty of fibre in the meals to help reduce the risk of constipation. Likewise stay well hydrated with regular glasses of water.
Talk to some-one who has had a hip or knee replacement recently. Things have changed quite a lot in the last few years so some-one who had surgery several years ago may only serve to deter you!
If you have a few weeks prior to surgery, get your strength up as much as possible. It really helps when you’re familiar with the exercises that you’ll have to perform after surgery beforehand. In this regard, a visit to the physiotherapist that you’d hope to attend beforehand (either at SSC or externally) is a great idea.
Perform your exercises but don’t overdo it. Sometimes patients who are really motivated have the perception that more is better. Perform your exercises as directed but then rest the affected limb. An ice pack straight after exercise helps minimise any rebound inflammation that you may get and is often as effective as analgesia.
Worries
Pain
Analgesia will all be in tablet form by the time of discharge. Ensure that you have discussed with the nurse looking after you what you should take for pain and when. You will be advised to take some analgesia regularly for the first few days and also given something to take if you develop pain between doses.
Clots
If anything, the motivation to get up and around your own home helps to reduce the risk. Continue to wear your white TED stockings for 6 weeks after the surgery as advised. The policy at the Sports Surgery clinic is also to continue on oral Aspirin (150mg daily) for 5 weeks.
Constipation
This is a common side effect of stronger opioid analgesia. Try to avoid to by staying well hydrated and eating plenty of fibre.
Wound
The dressing is changed prior to discharge and providing it remains dry, can be left intact for 7 to 10 days after your surgery. A follow-up visit to either the dressing clinic, your consultant or your general practitioner around the 2 week time point is usually advisable.
And Remember
You won’t be discharged until we think you are safe.
If you have any queries or concerns call for advice.
However, it is possible for committed and determined patients to aim for discharge two or even one day following their surgery. Remember, whilst a wish to do this is admirable, the most important thing is that you go home when safe to do so and that your overall safety or recovery is not compromised.
The advantages are that patients often feel much more at ease in the comfort of their own home. They are usually able to sleep much better in their own bed.
Who are ideal candidates?
Patients living relatively close to the hospital
Patients with few if any co-morbidities.
Younger patients
Patients who have some-one at home with them to provide some assistance in the first few days.
Tips
Read as much as you can about your surgery and recovery prior to the surgery so that you can hit the ground running.
Bring your own clothes and get back into them as soon as you can after surgery so that you feel more human and less of a patient.
Talk to your family so that some support is available.
Think about the home environment prior to surgery. Easy access to toilets, a walk in shower and downstairs bedroom are all ideal but not available in every household. Simple changes such as moving your bed downstairs may be an option or staying with a close friend or relative may even be considered. You will be able to safely ascend and descend the stairs prior to your discharge but if you can keep this to a minimum then all the better.
Try to avoid having pets running around
Beware of rugs and loose carpets. The last thing you need is a slip early in the course of your rehab and the risk of sustaining a fracture involving your new joint.
Think about meals. A few pre cooked meals in the freezer can make life a lot easier for you in the first few days. Try to get plenty of fibre in the meals to help reduce the risk of constipation. Likewise stay well hydrated with regular glasses of water.
Talk to some-one who has had a hip or knee replacement recently. Things have changed quite a lot in the last few years so some-one who had surgery several years ago may only serve to deter you!
If you have a few weeks prior to surgery, get your strength up as much as possible. It really helps when you’re familiar with the exercises that you’ll have to perform after surgery beforehand. In this regard, a visit to the physiotherapist that you’d hope to attend beforehand (either at SSC or externally) is a great idea.
Perform your exercises but don’t overdo it. Sometimes patients who are really motivated have the perception that more is better. Perform your exercises as directed but then rest the affected limb. An ice pack straight after exercise helps minimise any rebound inflammation that you may get and is often as effective as analgesia.
Worries
Pain
Analgesia will all be in tablet form by the time of discharge. Ensure that you have discussed with the nurse looking after you what you should take for pain and when. You will be advised to take some analgesia regularly for the first few days and also given something to take if you develop pain between doses.
Clots
If anything, the motivation to get up and around your own home helps to reduce the risk. Continue to wear your white TED stockings for 6 weeks after the surgery as advised. The policy at the Sports Surgery clinic is also to continue on oral Aspirin (150mg daily) for 5 weeks.
Constipation
This is a common side effect of stronger opioid analgesia. Try to avoid to by staying well hydrated and eating plenty of fibre.
Wound
The dressing is changed prior to discharge and providing it remains dry, can be left intact for 7 to 10 days after your surgery. A follow-up visit to either the dressing clinic, your consultant or your general practitioner around the 2 week time point is usually advisable.
And Remember
You won’t be discharged until we think you are safe.
If you have any queries or concerns call for advice.
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