Fast track recovery, or enhanced recovery – the method of rehabilitation which is geared towards getting patients out of hospital and on their way back to full recovery as soon as possible with the help of cutting-edge therapeutic solutions and advanced equipment – is a hot topic amongst the orthopaedic community. A recent two-day meeting of European orthopaedic experts demonstrated what an important issue it has become.
According to findings presented at the meeting, recent research and developments are advancing to the point where the possibility of certain patients undergoing total knee or hip replacement being discharged on the same day as their surgical procedure is becoming a tangible reality – and the case for fast track recovery is becoming stronger and stronger.
As the study points out, foot and ankle trauma is a very common and they can have severe long-term effects on the sufferer, with the potential to impact upon morbidity rates and long-term disability of elite athletes.
The Golden 48 Hours
The main message from the conference to the orthopaedic community was simple: be ready to question and change your current opinion on fast-track recovery, and prepare to collaborate with your peers to push the revolution along. As fast-track pioneer Dr Hendrik Kehlet, Professor of Perioperative Therapy at Copenhagen University, pointed out; “We have to look at all of the details of recovery — there is no simple solution. At this meeting, we covered blood management; pain management; [and] physiotherapy.”
Drawing attention to the fact that there is a substantial loss of muscle within the first 48 hours of a total knee and hip replacement procedure, Professor Kehlet pronounced this two-day period as a major barrier to a full and fast recovery. “When we know how to interfere with the loss of muscle function and solve the pain problem better,” he stated, “the whole physical recovery will be solved.”
Naturally, there has been a difference of opinion regarding what the perfect fast-track total joint replacement surgery procedure entails. Dr Luca Zagra of Milan commented; “It does not matter if the discharge is the same day, the day after or two days after surgery. Its focus should be on what can optimise the entire process of TJR surgery and recovery to reduce the period of hospitalisation, avoid useless added procedures and costs, and, at the same time, improve the satisfaction of the patients and minimise the risks of complications.”
Enhanced recovery at Fortius joint replacement centre
An Enhanced Recovery Pathway is at the forefront of many recent developments instigated by Fortius Clinic, particularly the establishment of the Fortius Joint Replacement Centre, based at Bupa Cromwell Hospital in London.
As Mr David Houlihan-Burne, Consultant Knee Surgeon, explains: “We have scrutinised and adapted the most modern, evidence based management techniques, in order to provide a seamless, unified, team based approach to this operation. The aim is to maximise our patient’s experience and to achieve optimal outcomes and a rapid return to function following their joint replacement.” He continues: “We have looked closely at pre- and peri-operative pain management, as well as patient education, and believe that optimising these three factors enables the best possible outcome for the patient.”
The advantages of fast track recovery are obvious, for both client and practitioner, but we also understand that every patient is different and requires a unique approach towards their treatment and recovery and we plan accordingly. To find out more about the approach at the Fortius Joint replacement visit their patient information website at www.fortiusjointreplacement.com