Same-day hip replacements at Saint Barnabas have patients climbing stairs
Join Dr. Henderson at a Free Educational Program to Learn More
Same Day Hip Replacement
November 3; 6:30 pm
Barnabas Health Ambulatory Care Center
200 South Orange Avenue, Livingston
Registration requested: 973-322-9908 or
Hip Replacement is on the rise. From 2000 to 2010, government statistics
show, the number of people between ages 45 and 54 who had total hip replacement
procedures jumped by 205 percent. And with new implants and improved surgical
techniques, these surgeries have kept increasing among baby boomers not
ready for the rocking chair just yet.
In fact, some people can now get a new hip without even spending a night
in the hospital. Saint Barnabas Medical Center’s same-day hip replacement
program allows patients who qualify to come in for surgery early in the
morning, gets them walking up steps by the afternoon and sends them home
for dinner that evening. You could say it’s not your father’s
“Appropriate patients don’t even have to pack a toothbrush,”
says Luciana C. Mullman, manager of specialty surgical programs at the hospital.
The program has been in operation for about a year, thanks to the insistence
of orthopedic surgeon
Timothy Henderson, M.D. “We were approached by Dr. Henderson, who was interested in
same-day hip replacement and wanted to provide it for his patients,”
says Brian George, administrative director for clinical operations. “We
are always looking for the latest and greatest technologies and care pathways,
and same-day joint replacement is the future."
Indeed, it’s the present, at least for hip surgery. (same-day knee
replacement is more complex and probably a few years off.) To qualify
for same-day surgery, patients need to meet certain criteria—for
instance, their body-mass index must be below a certain level and they
must be in generally good health beyond the hip.
Patients who meet the requirements and are approved for same-day surgery
by Dr. Henderson first attend an informational seminar with Mullman. “My
role is to educate all patients having joint replacement surgery,”
she says. “Whether they’re going to stay overnight or not,
it’s in their interest to learn about the procedure and ways to
take good care of themselves.”
The seminar covers many topics. Mullman talks about preparing the home
by removing potential fall hazards like throw rugs, having pre-cooked
meals at the ready, moving items to be easier to reach and having a support
system in place. “You won’t need someone 24/7, but you should
have a friend or family member ready to help,” she says.
Mullman then covers “pre-habilitation”—preparing for
surgery—by, among other things, using an antiseptic body wash the
night before surgery to help reduce infection and speaking with a physical
therapist about a home exercise plan, which patients are encouraged to
start prior to surgery. “The better shape you’re in coming
in, the better shape you’ll be in leaving,” she says. “We
have patients work on conditioning muscles that will help support their
Dr. Henderson talks about the surgery itself, what implants he uses, how
recovery will proceed and what medications he prefers for pain management.
“Our goal is to manage pain after surgery, so our pain specialists
and surgeons have created a pain management protocol to minimize discomfort,”
Patients having same-day surgery arrive at Saint Barnabas Medical Center
early in the morning and leave the medical center that evening. Dr. Henderson
enters the leg from the front in order to spare muscles and ligaments
from cutting, as is necessary in more traditional, rear-entry surgery.
Once the patient wakes up in the recovery room, he or she begins the rehab
process almost immediately. A physical therapist helps the patient get
out of bed and walk to a chair with crutches. Then it’s time to
begin walking around the unit. Eventually, patients practice on a small
set of stairs in the recovery room.
"That is really remarkable to see on the same day as surgery,”
George says. “A year ago they would walk with a walker on wheels.
These patients are skipping that step and going right to crutches.”
Patients must be able to handle 10 to 30 stairs before they can be discharged.
For most, that’s not a problem. “Our patients are leaving
the medical center in the evening on the same day they have surgery,”
George says. It’s really amazing; 15 years ago patients stayed a
week in the hospital. That changed to a three-day stay and recently to
one or two days. Now these eligible patients aren’t even here 12
And that’s just how today’s active hip transplant patients
want it. “Today, implants are much more durable than they used to
be, so people can undergo replacement procedures younger,” Mullman
says. “Some people put off having a replacement because they need
to get back to their routine quickly and don’t want a procedure
that will have them laid up for months. But it’s not like that now.
If you need to have your hip replaced, you don’t have to wait—and
you shouldn’t wait.”
To learn more about The Joint Institute at Saint Barnabas Medical Center,
visit our website or call 973.322.9908