Going home: NSHA's hip and knee action plan helping joint replacement patients such as Sandra Tufts return to comfort of home sooner

Sandra Tufts at her one-year follow-up appointment with Dr. O’Brien
Sandra Tufts at her one-year follow-up appointment with Dr. O’Brien

“Can I go home the day of my surgery?”

That was the question Sandra Tufts posed to her surgeon, Dr. David O’Brien, when she made the decision to go ahead with joint replacement surgery last summer.

A month later, the Timberlea resident became Dartmouth General Hospital’s first patient to have a same-day total knee replacement.

“I didn’t want to be in hospital. I wanted to be in the comfort of my own home with my husband and my dog,” Tufts said. “My surgery was at 7:30 in the morning, and after I showed that I could walk with my new joint, I was able to go home that afternoon.”

Tufts had support arranging pain medications and equipment to aide her recovery, and from a nurse who was a phone call away. She also followed the exercise plan Dr. O’Brien provided.

A year later she experiences occasional stiffness, but is mostly pain free, walks without a limp and is back to the activities she enjoys. It is a welcome change to the pain and frustration her knee caused her over the past several years. She had dreaded joint replacement surgery and wanted to put it off as long as possible.

An earlier scope of her knee gave her some relief, but as her osteoarthritis got worse, so did her pain and at times her knee gave out. Pain medications were a necessary part of her life and she didn’t want to go out walking around anymore.

Tufts credits Dr. O’Brien and the perioperative and physiotherapy team at Dartmouth General Hospital for a positive experience. “Dr. O’Brien is an amazing surgeon and the staff are wonderful,” she said. “I appreciated having the choice to go home. It made me feel so much better going into my surgery.”

When Tufts asked Dr. O’Brien about going home the same day as her total knee replacement, he knew it was a logical next step for some patients, based on the hospital’s success with same-day partial knee replacement surgeries. 

Dartmouth General Hospital has had a formal program in place since 2015 that supports some partial knee replacement patients to return home the same day as their surgery. Also known as unicondylar surgery, it replaces only one section of the knee joint.

Since launching that program, the team has helped more than 230 partial knee replacement patients avoid often unwanted, unnecessary and costly hospital stays, freeing up beds for others.

Joint replacement care continues to evolve under Nova Scotia Health Authority’s (NSHA’s) provincial hip and knee action plan.

While hip and knee joint replacement patients have typically stayed in hospital two to three days after surgery, a new wellness model is underway to help patients recover more quickly, avoid complications and return home within a day of surgery, as much as possible.

The hope is that the new supports being offered will give more and more other- wise healthy patients, like Mrs. Tufts, the choice to return home the day of their surgery. 

Visit www.nshealth.ca/hip-and-knee to learn more and see updates to the provincal hip and knee action plan.