New program promotes same-day recovery after orthopaedic surgery

Helping patients return to their normal lives more quickly following joint replacement surgery is now possible thanks to a new program that optimizes pain management and improves patient education.

The Enhanced Recovery After Surgery (ERAS) program allows patients to be discharged on the same day of their joint replacement surgery, which is often safer for patients and more comfortable as they can recover in their own homes.

Dr. Jesse Wolfstadt, Division Head of Orthopaedic Surgery at Sinai Health, was the orthopaedic lead for the development of the ERAS program. The program, he says, promotes a quicker return to normal by reducing symptoms like nausea and vomiting, all while promoting earlier mobilization.

“There is good evidence that complication rates and visits to the emergency department following surgery are lower in same-day discharge patients compared to those who are admitted as inpatients,” said Dr. Wolfstadt. “Same-day discharge is also advantageous for the health-care system, as it opens up beds for patients who require hospital admission.”

The cornerstone of the ERAS program is the innovative anesthesia team dedicated to facilitating quick recovery from knee replacement surgery through innovative methods such as effective pain management strategies and holistic aftercare planning.

Drs. Sharon Peacock and Josh Gleicher are anesthesiologists with a special focus on postoperative pain management. For same-day recovery, they utilize a unique short-acting spinal anesthetic that ensures optimal anesthesia during surgery while encouraging patients to stand and move shortly after the procedure. This is critical for preventing complications and promoting a faster recovery.

By integrating these advanced techniques and a strong emphasis on patient education and aftercare support, patients are empowered to recover comfortably in their homes, significantly improving their overall experience and outcomes.

"The introduction of the ERAS program in orthopaedic surgery is a fantastic initiative aimed at improving patient outcomes and accelerating recovery times,” said Dr. Ian Witterick, Surgeon-in-Chief for Sinai Health. “By leveraging innovative surgical techniques, optimized pain management strategies, and holistic aftercare planning, we are enabling patients to recover more rapidly.”

When the same-day discharge joint program started, many patients expressed anxiety about the overall safety of early discharge, said Chris Brown, a Nurse Practitioner on the Acute Pain Service team. Fortunately, a multidisciplinary team made up of surgeons, anesthesiologists, nurses, and physical therapists, collaborates closely to share insights and strategies that address individual patient concerns and ensure proper patient selection and preparation for same-day discharge. Each member of the team plays a critical role in ensuring holistic care tailored to the specific needs of each patient.

Brown notes that when patients were contacted after their discharge, they were appreciative for the opportunity to recover in the comfort of their own homes.