Doctors Join Early Release Parade

The march toward single-day joint replacement surgery goes on. The biggest impediment to patients returning to their homes following hip or knee replacement surgery, according to many surgeons, is pain and its management.

According to Suzanne Laurent, writing for news @seacoast, Thomas King, M.D. of the Knee, Hip and Shoulder Center in Portsmouth, New Hampshire, says that “There are three reasons for keeping patients in the hospital following surgery. [They are] the risk of wound infection, bleeding control and pain management.”

King has developed a surgical method that allows many of his patients to leave the same day they had a surgical joint replacement. Laurent says that he uses a combination of regional anesthesia, medications for pain control, a surgical antiseptic, and another agent that reduces bleeding.

“In the past five months” Laurent quoted King as saying, “97 out of about 200 patients were able to leave the same day after surgery. And that number is slowly increasing.” King uses a slow-release local anesthetic that, he says lasts three days and brings the pain level down to a 4 or 5 on a scale of 10.

He added, “In five years, surgeons will have to justify why they are keeping people in the hospital after a joint replacement, it’s better for healing to go home as soon as possible. People are sleep-deprived in the hospital and this is a serious issue for recovery.”

King told Laurent that he uses minimally invasive surgery and does not close the wound with clips or staples on the outside of the wound. He said that he also uses a new antiseptic that is nontoxic to tissues to sterilize the wound, and he claims an infection rate of 0% in the patients on whom he has used the antiseptic during surgery.

“Patients can lose a liter of blood during a joint replacement, ” King said. “I use an agent that reduces bleeding by 80 percent.”