Same-Day Joint Replacement: David's Story

David Spivack | Doylestown Health

"It was amazing! I had a hip replacement in the morning and by 12:30 pm I was walking through the door of my house and up and down the stairs," says David Spivack, 58, of Buckingham, Pennsylvania, a busy realtor who had same day joint replacement surgery at Doylestown Health's Orthopedic Institute.

Before surgery, David experienced pain caused by osteoarthritis in his left hip. Osteoarthritis causes joint discomfort, swelling and stiffness by wearing down the slippery cartilage that keeps bones from rubbing together.

"I'm passionate about tennis," explains David, who continued to play even though his hip slowed him down.

Realizing it was time to consider surgery, David visited Thomas Vikoren, MD, a fellowship-trained orthopedic surgeon at Doylestown Health who recommended total hip replacement and informed David that he was a candidate for the Same-day Joint Replacement program.

"Patients must be highly motivated, in good mental and physical health and willing to participate in intensive physical therapy to qualify," explains Dr. Vikoren.

After careful consideration, David, a busy realtor with Keller Williams Real Estate, chose the same-day option, "I scheduled my surgery for January 2, a time I knew my business would be slower."

David's Story: Same-Day Joint Replacement Ace

With You Every Step of the Way

"This has been an unbelievably positive experience," says David. "The communication and after-care were excellent and there was a real team approach. Dr. Vikoren called me the day of surgery and the day after, it was easy to get the right team member on the phone to get answers."

A month before surgery, David met with physical and occupational therapy, as well as the orthopedic patient navigator who coordinated his individualized care plan.

"Physical therapy included stretches and exercises prior to surgery to help make recovery easier," says David.

"My surgery was early in the morning, and I arrived home at 12:30 pm to find a visiting nurse and a physical therapist waiting at my front door," says David, adding, "They made sure that I knew how to safely get in and out of the house, up and down the stairs, and to the bathroom and shower. They checked that everything was set up appropriately and that it was a safe environment.

"The next morning, the visiting nurse came back to check my vitals and to make sure I was OK," explains David.

"Occupational therapy and physical therapy came to my home as well. After that, I began regular, outpatient physical therapy. Physical therapy at the hospital is wonderful - my therapist understands my goals" says David, who is focused on getting back on the tennis court as soon as possible.

Back in Action

"This has been an amazing experience," says David. "It's hard to believe that I had a total joint replacement and was back on my feet the same day. I was driving and back to work in two weeks!"

Same-day Joint Replacement for Rapid Recovery

With new advances in joint replacement techniques, patients at Doylestown Health's Orthopedic Institute can have their joint replacement surgery and return to the comfort of home all in the same day.

Revolutionary changes are taking place related to joint replacement, In the late 1990s, hospital stays of one-two weeks were common. In recent years, one-two night stays became standard. Today's advanced surgical techniques and innovative pain management options have elevated care even further so that leaving Doylestown Hospital within hours after joint replacement is now possible.

Patients must be in good health, willing to participate in an intensive physical therapy program and able to have someone with them in their home for 48 hours after surgery. The orthopedic surgeon may recommend same day joint replacement, but the decision is up to the patient and his or her insurance company.

The same-day rapid recovery option appeals to people who want to avoid an overnight hospital stay and prefer to recover at home. It is an alternative that gets patients back to doing what they want to do, sooner.

How it Works

Advanced, minimally-invasive approaches to surgery and breakthroughs in anesthesia and pain control allow patients to be up and walking right after hip replacement surgery. Components include:

  • "Pre-hab" physical therapy to build strength prior to surgery
  • Sophisticated, minimally invasive procedures using a gentle approach where cutting muscle is avoided
  • Advanced pain control methods allowing patients to walk right after surgery
  • Home health therapy upon arrival home

"Pain control is one of the biggest questions people have about a same-day joint replacement," says Dr. Vikoren, noting that advances make it possible for patients to be up and walking almost immediately after surgery with less pain.

"We use a short acting spinal anesthesia in conjunction with various methods of pain control (known as multimodal pain management). For example, for knee replacement surgery we use a technique called adductor canal block which blocks the nerve that affects pain without blocking motor function. This way, patients can still use their muscles, but pain is mitigated."

About Clark Outpatient Rehabilitation Center

Located in the Ambulatory Center on the campus of Doylestown Hospital, Doylestown Health's spacious new Clark Outpatient Rehabilitation Center provides a convenient one-stop option for multidisciplinary outpatient therapy. Seamlessly connecting consultation, diagnosis, intervention and treatment services with physical therapy, occupational, hand and speech therapy, the Clark Outpatient Rehabilitation Center is staffed by licensed therapists only.

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