Fife first in Scotland to provide day-case hip surgery

Published: Tuesday 18 Dec 2018

Ortho Team with Michael Sullivan

Ortho Team with Michael Sullivan

NHS Fife has become the first health board in Scotland to pilot successful day-surgery hip replacement.

The average length of hospital stay for a hip replacement in Fife is around three days and the new technique reduces this stay to less than 12 hours.

Enhanced recovery, which was developed in Copenhagen, veers away from the traditional use of spinal anaesthetic in favour of a more localised numbing. Numbing the capsule, tendon and ligaments around the hip joint means the muscles are still working and the patient can generally walk soon afterwards.

Director of Surgery at NHS Fife, Mr Edward Dunstan, carries out around four joint replacements each day. He said: “One thing we have got to be clear about is that throughout this project we have never compromised on patient safety or quality of care. It is all about empowering patients and empowering members of staff. Using spinal anaesthetic means the legs are totally numbed and are unable to be used for up to six hours. The new technique gets the legs back to work sooner, reducing the risk of losing muscle mass, clots, and increasing oxygen saturation in the blood, which generally helps patients feel much better.

“Mr Michael Sullivan was the first day case hip replacement we performed – he came in at 7.30AM, had his operation at 9.30AM and he was home at 6.30PM. Since then we have had a series of similar surgeries.”

Across Scotland there are around 15,000 major joint replacements carried out every year. Day case hip surgery is suitable for around 15% of patients, but can significantly reduce their stay in hospital.

Michael Sullivan, from Kennoway, was first to undergo the procedure earlier this month when he received his second hip replacement at the Victoria Hospital, Kirkcaldy. He said: “The first surgery I had, I was a bit apprehensive because you did not know what you were about to go through, but the second time was completely different. It was night and day. The first surgery I felt sick afterward and I lay in bed for about four hours for the anaesthetic to wear off, and by then it was too late to start doing any exercises. The second operation I was up within an hour and walking about – there was no pain, I never felt nauseated and I was able to walk a lot freer. The team were excellent right from the start, the explanation, advice, and it was the quickness. The last time I was listening to Beatles music during the surgery after hearing horror stories – but this time it was the best two hours sleep I have had in years!”

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