Double delight as patients discharged on same day as ‘bilateral’ joint replacements

The simple joys of playing hide and seek with the grandchildren had become a distant dream for one Shropshire woman, thanks to unbearable pain in her hips.

But that has all changed for Ruth Denney, 71, after she underwent bilateral hip replacement surgery – meaning she had both hips replaced in the same procedure – at The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry.

Ruth, from Onnerley, near Market Drayton, also now holds a unique record – having become the first bilateral hip replacement patient to be discharged home on the same day as her surgery.

The hospital has also achieved the same feat for its first bilateral knee replacement patient discharged on the day of surgery. Paul Garstone, 66, from Shrewsbury holds that distinction, having gone under the knife for ‘unicompartmental’ knee replacements in June. This means only the damaged compartments of his knees were replaced, which is a less invasive alternative to total replacement.

Both Ruth and Paul were seen through the hospital’s Enhanced Recovery Programme. This is a modern, surgically-led, evidence-based approach that helps patients undergoing surgery get back to health as soon as possible following their operation. It ensures that a patient's health is optimised prior to surgery, that improved pain management is introduced during their hospital stay, and that post-operative mobilisation is achieved earlier.

Ruth had her bilateral hip replacement under Consultant Orthopaedic Surgeon Mr Niall Graham.

She said: “I hadn’t been able to walk properly for about two years. I had the operation in the middle of July and, just six weeks or so later I was able to be outside playing hide and seek with my grandchildren, who are five and seven. I hadn’t done that for at least 12 months, if not longer, so it was special for me.

“The operation all went so smoothly. I was in the operating theatre at 9.10am and out again at about 11.30am, and straight into recovery. I remember I had a pork dinner at 12 and was then up and out of the bed at about 12.30pm. I was home by 5pm, eating a takeaway curry for tea!

“When I was discharged, the Enhanced Recovery Team gave me a number to call if I needed any help, so I knew that support was there.”

Paul was away on a work trip in Slovakia in his role as a Supply Chain Director for a German Automotive Parts supplier, when his knee gave way with a crack on a flight of stairs and he fell.

He managed to get home in a lot of pain, and was subsequently seen at RJAH by Mr Pete Gallacher, who diagnosed extensive damage to the cartilage that would mean a replacement knee was required. While waiting for that procedure, his left knee gave way too, and a scan led to the same diagnosis.

He opted for bilateral knee replacement – having both done in the same operation – and the procedure took place back in June.

“My recovery has gone really well,” said Paul. “At first I walked using crutches, even just to go to the kitchen, but after about 10 days I got up and realized I’d forgotten to take them with me, so from then on I mostly walked around the house without them.

“When I realised I was going to need surgery, I actively decided to lose weight and that has helped a lot. I’ve lost 4st in total, and since I had my knees done I’ve lost about 20lbs.

“I remember I went in for surgery at around 12 noon and was back on the ward at 4pm. I was up walking around at 7pm, and was back at home by 9.45pm. It was remarkable.”

The Enhanced Recovery Team has demonstrated that the Enhanced Recovery Pathway protocol is both safe and highly effective, achieving a reduction in length of stay (LOS) by over 80%. 

More than 20% of patients on the pathway are discharged on the same day (Day 0), and over 90% are discharged within 24 hours. This significant decrease in LOS is associated with improved patient outcomes, including reductions in mortality, morbidity, and infection rates. 

Furthermore, patients report a better overall experience, particularly after discharge, thanks to a dedicated support team who provide ongoing care and guidance in the community. 

Pictured:

Left: Ruth Denney with Consultant Mr Niall Graham, and some of the clinical team that cared for her during her patient journey at RJAH.

Right: Paul Garstone with Consultant Mr Pete Gallacher, and some of the clinical team that cared for him during his patient journey at RJAH.