Newfoundland and Labrador hopes to have 20 percent of hip or knee replacement surgeries reduced to same-day procedures by this fall. (Paul Daly/CBC)
Two hip and knee replacement patients are warning that the Newfoundland and Labrador government’s plan to have some of the procedures performed without a hospital stay will lead to discomfort or even complications.
By the autumn, the government aims to have 20 per cent of hip and knee replacement operations performed as same-day procedures. The goal is to keep hospital beds available for other surgical patients, with waits for joint replacement surgeries among the longest in the province.
Catherine Dempsey, who had both hips replaced a few years ago, says her procedures and recovery have gone well, but the extra time in the hospital has helped.
“I had a slight drop in oxygen, so they locked me up and watched me all night,” she said Monday.
When they did the second surgery, she had a better idea of what to expect.
“And then I knew that this time the physical therapist came in and asked you to go up and down a step, they’d send you home right away,” she said.
“I didn’t feel comfortable at the time. I felt worse than after the first one, so I refused to take the step.”
Dempsey said she was discharged after 48 hours in the hospital instead of the then-planned 36 hours.
Paul Marino said he probably could have gone home after having surgery to replace both knees two years ago, but it would have been difficult because the painkillers he was prescribed were too weak and his hospital stay let it get something stronger.
“It was very painful and the recovery was very slow. It wasn’t the best.”
A pre-pandemic problem
There are about 1,800 people in the Eastern Health Region alone waiting for hip or knee replacement surgery right now, according to health officials.
About 1,550 are ready to go immediately, Dr. Will Moores, chief of orthopedics at Eastern Health, said Tuesday.
Moores, who has been a staff surgeon at Eastern Health since 2013, said that except for the first year of building his practice, the wait time is usually about a year. Today, he said, the wait time for a standard hip or knee replacement can exceed two years.
About 1,800 people in Newfoundland and Labrador’s Eastern Health Region are waiting for hip or knee replacement surgery. (Bright097/Shutterstock)
“There’s definitely no shortage of work,” he said.
“I probably wouldn’t say the system has failed. Is that where it’s going? It will be hard to deny it.”
The onset of the COVID-19 pandemic cost about six months of lost time for hip and knee replacement surgery, Moores said. Some surgeries have been performed, he said, but not standard elective surgeries or joint reconstruction.
The October cyberattack on the health care system knocked the hip and knee replacements out of the system for about six weeks, he added.
“You’re looking at more than seven months of the last two years that were lost,” he said.
While long wait times were a problem long before COVID-19, Moores said, the pandemic has certainly made things worse.
“Our ability to complete as many joints as possible was actually starting to decline before the pandemic, and that’s more a factor in the strain on the whole system, specifically with the beds and being able to recruit and retain enough nurses to run those beds, ” he said.
Moores said it is becoming common elsewhere for knee and hip replacement surgeries to become same-day procedures.
Any hospital that didn’t before the pandemic transitioned relatively quickly to maintain capacity while still performing operations, he said.
Moores said the 20 percent goal won’t necessarily shorten the overall surgery backlog, but it will shorten the backlog for a certain population of generally healthier patients.
“We can do more joints and not require more beds,” he said.
“That national guideline for standard hip and knee replacement is six months…I think the ideal situation here is that our wait times will come down to the national guideline that if you see a standard hip or knee replacement, you will you can reasonably tell them that your surgery will be completed approximately six months later.”
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