Surgery game-changer: Same day knee replacements

For Sandy Kaszubowski, simple tasks like going to the store had become incredibly painful.

“I remember standing in line at the deli counter one day in excruciating pain thinking, ‘I can’t take this anymore,’” she recalls.

Kaszubowski, a member of the physician relations team at Advocate Lutheran General Hospital in Park Ridge, Ill., had known for some time she’d need a knee replacement. A vacation last year had led to a meniscus tear which resulted in arthroscopy, a minimally invasive surgical procedure, on her right knee and after the procedure, she knew the news wasn’t good.

“I remember looking at the surgeon after arthroscopy and knew something was wrong,” she says. “It seemed like he was in mourning. In mourning for my knee, apparently.”

In fact, Kaszubowski had no cartilage left in her right knee. Since January, she had been in constant pain.

“Walking had become difficult,” she says. “With every step, I could feel this burning sensation in my leg.”

So a knee replacement was the logical next step. But what type of surgery should she get?

As an associate at Lutheran, she was aware of the two different options, the main difference being the length of time spent in the hospital recovering. Physicians she spoke to touted the recovery time with same day patients, but Kaszubowski was concerned.

“I remember when I spoke to Dr. Bresch the first time about my options,” she says. “He said ‘You’re a candidate for same day’, and I remember thinking, ‘No way! I don’t want to be home managing that pain all by myself.’ It was scary to me.”

“Sandy’s fears are very typical of what I see with same day candidates,” explains Dr. James Bresch, an orthopedic surgeon affiliated with Advocate Lutheran General Hospital in Park Ridge, Ill.

“The number one fear is what we like to call abandonment. In other words, patients are afraid after they leave the hospital, they will be on their own, in pain, without the safety net of a hospital and caregivers.”

But after a little research and a couple key conversations with experts at Advocate, Kaszubowski started seeing the benefits of same-day surgery and understood that her fear of ‘abandonment’ couldn’t be farther from the truth.

“I talked to a colleague who I respect and she said, ‘You’ll be more comfortable at home, and there are so many resources to ensure you are prepared and not managing your recovery on your own.’”

Kaszubowski says that’s when it clicked that this could work.

“There are a lot of common misconceptions about same day outpatient knee replacement surgery,” says Dr. Bresch. “First and foremost, people think the actual surgery and pre-operative and post-operative protocols are the same as 10 years ago when the surgery was done as an inpatient, and they get concerned. The truth of the matter is the protocols have changed, and that’s what allows us to do a knee replacement as an outpatient procedure with such success.”

When patients hear that the protocols have changed, and Dr. Bresch explains the benefits of doing it as an outpatient, many, if not all patients, have the same reaction as Sandy and get excited about the possibility of being home the same day they have their procedure, he explains.

And so the decision was set. Kaszubowski had her procedure in early November at 7:30am.

By noon, she was at Portillo’s ordering a chopped salad with her husband.

“Sandy’s case is textbook,” says Dr. Bresch. “After they realize their fear of handling recovery on their own is unwarranted and do some research on the new protocols, almost all my patients are asking for same-day surgery. Not only is there a more rigorous pre-operative assessment with this type of surgery, but the multi-modal, multi-department protocols which include everything from the types of anesthesia patients receive to interoperative changes, lead to less pain post operation. Couple that with more personalized care and autonomy in one’s own home, and what more could a patient ask for?”

Three weeks post-recovery, Kaszubowski is so thankful that she chose same day surgery.

“I was concerned, but I figured out early on it was all about the preparation,” says Kaszubowski. “I had ordered a hospital bed so I could sleep downstairs and rented a Game Ready ice machine that helps ice my leg while I rest. Truly the hardest part of my day is physical therapy. Already, I’m standing in line at the deli counter feeling 100 times better than I did before surgery. Truly, this type of surgery is a game changer.”

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