Rapid recovery programmes were first described by a Danish surgeon Henrik Kehlet in 1997 . The aim is to target factors that delay the post operative recovery following your total hip and knee replacement surgery to help an individual recover faster and safely. The rapid recovery programme is evidence based that requires a multimodal approach via a coordinated clinical pathway. A multidisciplinary approach will help achieve the best possible outcome for our patients.
We know that osteoarthritis of the hip can significantly affect the quality of life. Osteoarthritis of the hip occurs less commonly in patients as young as in their 40s and more commonly in the 60 to 70 years old group. Patients with femero-acetabular impingement syndrome and hip dysplasia could get premature arthritis of the hip joint.
- Total hip replacement surgery has been shown to provide an excellent quality of life improvement.
- Over the last decade rapid recovery programmes have successfully demonstrated benefits to individuals undergoing total hip replacement surgery.
Individuals with arthritis in their hip can enter a rapid recovery joint replacement pathway following discussion with Mr Parminder J Singh at any of his consulting locations in Melbourne, to assess their eligibility. The individual case complexity will determine if you are suitable to enter a rapid recovery programme.
Rapid recovery is a technique that has a number of advantages, such as:
- helps reduce the pain after surgery
- enables early mobilization
- reduces the post-operative medical complications
- reduces the length of stay in hospital
- improved pace and quality of recovery
Rapid recovery following your hip replacement utilizes a structured approach to reduce the multiple variables associated with each individual.
The rapid recovery programme can be divded into 3 main phases; namely the preoperative, intraoperative and post operative phases.
Pre-operatively – Prior to your hip replacement surgery, Mr Parminder J Singh will arrange for you to see a peri-operative physician. The physican will perfom a detailed medical assessment and help optimse any medical conditions you have prior to your surgery. For example if there is any pre-operative anaemia, this should be improved prior to any surgery to enhance your recovery. Likewise, if you have any diabetes, this will need to be assessed and opimised prior to your surgery to mininise any risk of post operative infection.
With respect to eating prior to your surgery, solid food is allowed 6 hours prior to your surgery. However, a more cautious approach in patients with morbid obesity and or poorly controlled diabetes may require further consideration.
With respect to pre-operative hydration, clear fluids 2 hours prior to your surgery helps reduce dehydration . The selection of pain relief before your surgery 2 hours before combined with following your surgery is important with respect to your mobilization.
Intra-operatively – Parminder J Singh will perform a minimally invasive anterior or mini posterior approach (direct superior approach) to implant the hip replacement.
- Injection of local anesthetic into the soft tissue around the hip joint will help reduce the pain and reduce the amount of pain medication immediately after your surgery.
Post operatively – Following your hip replacement surgery, opioid based medications can produce more side effects to your body leading to a slowing of your recovery. In particular, opiods can increase your post operative nausea and delay recovery. Reducing the number of drains such as urinary catheter can also help enhance your recovery. Trying to mobilize 4-6 hours on day 1 wearing your own clothes under the supervision of the physiotherapist is an important step to take on your journey to rapid recovery. A rapid recovery joint replacement programme will help improve the patient experience to a level where individuals feel confident and safe to return home. The rapid recovery programme is not suited for everyone; however, Mr Parminder J Singh will discuss your eligibility on a case-by-case basis. If you are interested in exploring the option of a rapid recovery joint replacement programme, you can schedule a personal consultation with Dr. Singh, at any of his consulting locations in Melbourne.