MSH JOINT HEALTH
STRIDING FORWARD Same-day joint replacement surgery leading the way Dr. Evan Watts, orthopaedic surgeon
| BY JACLYN TERSIGNI
uestion: What costs more than $1 billion each year and requires about 594,000 days’ worth of hospital stays? Answer: Hip and knee replacement surgeries. More than 123,000 joint replacement surgeries took place in Canada in 2016 and 2017, at an average cost of $9,100 per surgery. Beyond the associated price tag, these inpatient surgeries come at a cost for patients, too: laying in a hospital bed, they’re more susceptible to infection and their return to everyday living is delayed. Things are beginning to change. Helping lead the charge is MSH and its newly instated same-day joint replacement program. Using minimally invasive techniques, new modes of ad28
Markham Stouffville Hospital Foundation
ministering anaesthesia and a dedicated at-home recovery plan, the program will see patients return home within hours, not days, of having their knee or hip replacement procedures. “We have aspirations to offer more surgeries to more people, although our biggest goal is to try to improve the patient experience,” says Dr. Evan Watts, an orthopaedic surgeon who specializes in knee and hip replacement. He joined MSH in July, tasked with initiating the same-day surgery program. “In my opinion, people eat better, sleep better and they recover better at home. It also decreases the risks of complications associated with being in a hospital.” When a surgery that previously required a hospital stay of two or three days becomes an outpatient surgery, some skepticism — Is it safe? Is this simply a cost-reducing measure? — is
expected. But, Dr. Watts explains, the same-day model is simply an improvement upon previous methods, based on decades of research on operative techniques and pre- and postoperative care. Surgeons at MSH are trained in muscle-sparing techniques that reduce the amount of trauma to muscle and tissue, which helps aid patient recovery, especially early on in the postoperative period. Anaesthesiologists play a crucial role as well, meticulously planning the form and dosage of anaesthesia so that it offers an appropriate level of pain management without inducing high levels of nausea and immobility (often the cause of longer stays in hospital). “Historically, if we look back at the early days, people were admitted the night before and they were staying for a week in hospital,” Dr. Watts says. “Really what we’ve done is perfected that process.”