Years of intensive equine riding events and weightlifting took a heavy toll on Shelby Roblin’s knees – so much so that she has lived with pain for the past 10 years.
When the COVID-19 pandemic forced the postponement of elective surgeries across B.C., she expected she would be waiting a lot longer for relief.
Instead, thanks to innovative planning and two enthusiastic surgeons, she got her long-anticipated partial knee replacement in December at Royal Inland Hospital in Kamloops.
Now she is looking forward to the second procedure, particularly because she knows that once again, no overnight stay will be required.
“My surgery was in the morning; I saw the physio at one and I left the hospital at 2 p.m.”
Shelby has been in hospital before when she had to stay for several nights and “it was not very pleasant.”
So when her orthopedic surgeon Dr. Chris Dusik told her she would be able to sleep in her own bed the night of the surgery, she was ecstatic.
“Dr. Dusik did a fantastic job. I have had no pain or infection. I slept well and was up walking about in the morning. I would recommend going home that day to anyone who fits the criteria. It is just so much better for recovery,” said Shelby.
She added that because the hospital did not need to find a bed for her, she was able to get in for her surgery much sooner. Seven days after her surgery, Shelby was still glowing about her short hospital stay and the success of her knee replacement.
As a patient, Shelby met the criteria for the program. She is 51 and had her adult son at home to provide some support during the recovery period. Basically, suitable patients must be fairly young, reasonably healthy and have someone at home to help them.
Until recently, all patients getting hip, knee or shoulder replacements stayed in hospital a minimum of one night.
Dr. Dusik and his partner Dr. David Cruickshank proposed the idea of a day-care joint program for their patients as a solution to a difficult problem for people who had been waiting years, often in pain, for orthopedic procedures.
The team started with hip replacements, moved into partial knees, with shoulder replacements coming next.
The results have been “incredibly successful,” with virtually no complications, said Dr. Cruickshank. He said patients are overwhelmingly positive about the experience. When the surgeons check in with them the next day, they are all rested and up using their new joints with minimal pain.
Both surgeons are looking forward to broadening the program to include more patients once more physio resources are available.
“Expanding the program would mean the ability to complete significantly more surgeries in the context of bed shortages. Ultimately, this would translate into shorter wait times and decreased health-care costs,” said Dr. Dusik.
There’s no reason not to expand when the cost savings and positive feedback from both patients and providers are considered, added Dr. Cruickshank.
Denisa Urban, who works in surgical process improvement in Kamloops, credits the surgical improvement team for creating something really positive during the challenging circumstances of the pandemic.
“We have a very dedicated multi-disciplinary team who is keen at preserving patient safety and satisfaction. The results are due to a really fantastic team who came together to achieve a common goal,” she said.
Dr. Tyler MacGregor, perioperative medical director at Royal Inland Hospital, performs most of the orthopedic procedures in Williams Lake and said patients are extremely grateful for the new program.
Bonnie Markland was the first patient at Cariboo Memorial Hospital to have her surgery in the morning and head home the same day. Dr. MacGregor proposed the idea for her hip replacement, noting she was a prime candidate.
It also appealed to her because it meant she would have surgery earlier given she wouldn’t need to stay overnight in hospital.
“I had been living in pain for about four years so I was willing to do that. I was a little nervous about how the pain would be managed, but it worked out fine. I would highly recommend it. It was great to be able to have the surgery locally and go home to my own bed.”