Updates on current orthopaedic news from around the world.
- Journal of Bone and Joint Surgery(Br & Am)
- American Academy of Orthopaedic Surgeons
- The Mayo Clinic
- News from various leading orthopaedic meetings
Enhanced recovery after Joint replacement Surgery:
This is a programme aimed to reduce physical and psychological trauma of surgery and enhancing the process of recovery especially after joint replacement surgery.
Enhanced Recovery often referred to as Rapid Recovery Joint Replacement has been around for over 14 years. It is NOT a New Technique but an Enabling Process.
The Enhanced / Rapid Recovery Joints Programme was developed in Sydney By Professor L. Kohan and Dr. Dennis Kerr. Dr. Nizam has been a part of this team working closely with them for over 7 years conducting several research projects and written research articles on this programme. (read more)
Enhanced Recovery or Rapid Recovery Programme:
- Reduces physical and psychological Trauma of Surgery.
- Less Pain after Surgery
- Less Nausea and Vomiting
- No Drug Side-Effects or Sedation
- Rapid and Improved Rate and Quality of Recovery
- Less Muscle Weakness
- Patients being able to Walk within 4 hours after joint replacements
- Less Post Surgical Complications (deep vein thrombosis, pulmonary embolism and infections)
- No Inpatient Rehab
- No Urinary Catheters
- Discharged Home after a Single overnight stay in hospital. (Individual outcomes may vary)
The key elements included in the Enhanced Recovery after Joint Replacement surgery pathway are:
- Patient Education (especially joint school)
- Preoperative nutrition
- Active peri-operative oxygenation
- Active prevention of hypothermia during and after surgery
- Regional anaesthesia to enable early and independent mobilisation
- Minimally Invasive Surgery and control of blood loss
- Avoidance of peri-operative encumbrances e,g, drains, epidural catheters, pca’s – these “attach” the patients to a bed and prevent mobility
- No systemic morphine use (to avoid drowsiness, Sickness and Nausea after surgery)
- Enhanced preoperative and postoperative nutrition
- Early post-operative mobilisation
- Early Discharge home when safe, so patients are able to recover in their own home environment
- Less Risk of Infection and DVT / PE
When Can patients drive after total knee replacements?
- Early Resumption of Driving within 3 weeks following patient-specific instrumented total knee arthroplasty: an evaluation of 160 cases. I. Nizam, A Batra, S. Gogos. BMJ Journals – JISAKOS 28 Mar 2019. doi: 10.1136/jisakos-2018-000268.
This paper that was published by Dr. Nizam and his team highlights that minimally invasive surgery with enhanced recovery and rapid return to normal activities enable patients to drive early in some cases even few days after knee replacement surgery.
Please read the paper in its entirety to understand more. Most of the movements in a car are usually at the foot and ankle. SO as long as the patient is comfortable, alert and able to get in and out of a car and able to to move the hp and knee atleast 20-40 degrees, it should be fine to drive – according to this study that looked at over 160 joint replacements and when they were driving.
When Can patients drive after Anterior hip Replacements?
- When do patients drive after minimally invasive anterior hip replacements? A single surgeon experience of 212 hip arthroplasties.Batra A, Gogos S Nizam I, Sicot J. 2018, 4, 51.