Enhanced Recovery Hip Replacement programme
The Enhanced Recovery Hip Replacement programme aims to optimise every element of your care from pre-assessment to discharge from Mr Apthorps care. Mr Apthorp aims "to encourage early optimal recovery for patients allowing them to quickly resume their normal lifestyle, whilst minimising the risk of complications".
What you can expect
At your first appointment Mr Apthorp will take time to discuss your problem with you and will conduct a thorough assessment. He may require up to date X-rays so may send you for an X-ray, which will be done on site at that time (please bring any previous X-rays you have with you to your appointment). Mr Apthorp will then review you again with your up to date X-ray before you leave and discuss his findings and any treatment options with you. Should surgery be required Mr Apthorp will usually give you a date for surgery at this first appointment.
Prior to your admission you will be asked to attend a pre-assessment clinic, which lasts between an hour and a half and two hours. Here you will be seen by a pre-assessment nurse and physiotherapist, who will identify any issues you may have and prepare you for discharge, pre-empting any problems you may have when you leave the hospital. They will discuss your surgery with you and answer any questions you have.
The pre-assessment nurse will go through your medical history, take blood tests, complete an MRSA screen and any other tests such as an ECG (echocardiogram) which may be required depending on your age or medical history.
You will also be seen by a physiotherapist who will explain what will happen immediately after your surgery and your expectations thereafter. They will measure you for walking aids, teach you to use them and show you how to manage the stairs after your surgery. You will be given the walking aid to take home with you so you can familiarise yourself with them.
You will be admitted on the day of your surgery. This is often early, so for those coming from a distance a list of local accommodation can be provided, where you can stay the night before. On arrival at the hospital you will be welcomed by our reception team and a member of the ward staff will collect you and take you to your individual room with en-suite.
You will meet your nurse who will clerk you in, checking all your details and basic observations (blood pressure/temperature).
Mr Apthorp will visit you prior to your surgery and you will have another opportunity to ask any questions which you may have. He will ask you to sign the consent form, if you have not already done so and at this time he will also mark the leg with an arrow.
You will also be seen by your Anaesthetist prior to surgery, who will discuss the anaesthetic options. We use a anaesthetic protocol (dependant on individual medical histories) which optimises our patients enhanced post-operative recovery, providing good pain control, allowing early mobilisation and reducing any post-operative complications such as nausea.
At the appropriate time you will be taken to theatre for your surgery by your nurse, who will take you into the anaesthetic room. Following your surgery you will go to the recovery ward, prior to returning to your room. You will be away from your room for approximately two hours.
Wherever possible, once recovered you will have the opportunity to get up and walk on the day of your surgery. This reduces pain and stiffness and gives patients' confidence.
The following day you will be walking with your walking aid around the ward and you will commence your exercise programme with the physiotherapists. Prior to discharge they will ensure you are able to walk up and down the stairs and are confident with your exercise programme, which you will be expected to do at home.
Mr Apthorp will visit you each day to monitor your progress and answer any queries you have prior to discharge.
Patients normally return home between 24 and 48 hours after surgery. They would be expected to be comfortable walking with their walking aid, safe walking up and down stairs, able to wash and dress and tend to their daily needs.
Patients naturally experience stiffness initially when sitting which eases when walking. Over the next few weeks patients enjoy increased mobility, walking further and decreasing the need for walking aids. By six weeks patients mostly walk unaided. Although minimal pain, they still experience some discomfort and stiffness, particularly after prolonged use. Driving can be resumed from six weeks and depending on the nature of their work, patients can return to their employment between six and twelve weeks.
Many of Mr Apthorps patients are able to enjoy sport after their surgery, these sports include golf, tennis, swimming, cycling, horse-riding and even wind-surfing. You will be advised by Mr Apthorp and your physiotherapist of when you can return to sport but a rough guide of the common sports can be seen below:
Swimming - once the wound has healed fully, Cycling - six to eight weeks, Golf - eight to twelve weeks and Tennis - twelve weeks
Follow up appointments
Local patients will be given an out-patient appointment two weeks following surgery to check their wounds and have physiotherapy. Those who live some distance away can arrange their wound check with their local Practice Nurse and their physiotherapy with a local private physiotherapist.
Mr Apthorp will review patients six weeks post surgery at the Spire Sussex hospital. Your appointments will normally be given to you prior to your discharge from the ward.
Should you have any concerns or queries following discharge from the hospital you can contact the hospital directly to discuss these and if necessary an appointment can be arranged with Mr Apthorp.