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Enhanced Recovery After Knee Replacement Surgery with Dr. Lee Schmidt

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By:

Laura Tenbus

January 10, 2018
Joint replacement surgeries have dramatically changed over the past few decades. In the 1980's, patients who had a hip or knee replaced would stay in the hospital for approximately two weeks. Now, they can go home in as little as one to two days! Patients are up and moving within hours of their surgery and are able to immediately begin physical therapy.

In this segment of "Greater Living," Dr. Lee Schmidt, Chief, Division of Orthopaedics, and Director of the Joint Replacement Center at GBMC, and hosts Mary Beth Marsden and Don Scott discuss Enhanced Recovery After Surgery (ERAS) protocols for knee replacement patients.

Dr. Schmidt explains why the patient experience is so different now than it was 30 years ago. On top of advancements in surgical techniques and pain management, the overall approach to joint replacement has changed. Doctors are now focusing on the patient's entire experience and the quality of that experience rather than solely on the procedure. In the past, patients weren't allowed to eat or drink after midnight the day before surgery to prevent sickness during the procedure. While this served its function, it also led to dehydration and malnutrition in many patients, which can cause complications after surgery. Surgeons now know that proper hydration and good nutrition help patients to heal more quickly. The approach to medications has also changed significantly. Surgeons are moving towards short-term and local anesthesia rather than long-term anesthesia and are reducing the use of narcotics (such as OxyContin) for pain management.

Mary Beth and Don also spoke with one of Dr. Schmidt’s grateful patients to learn more about ERAS and the joint replacement process from her point of view. 20 years ago, Dr. Linda Whitby was hit by a car as she walked down a sidewalk. She sustained several injuries but put off getting them treated — something she now strongly encourages people not to do. As an OB-GYN, she was so used to caring for other people that she neglected to take care of herself and dealt with chronic pain in her knee until she could no longer bear it. She was falling frequently and described her knee as feeling like a "mushy grapefruit." She was shocked that her knee felt stable immediately after surgery. Now a month out, her knee is healing well and she is on track for a full recovery.

Even though technology and treatments have drastically improved over the years, joint replacement surgery continues to be a serious procedure. Dr. Schmidt emphasized that patients still need to be diligent with post-surgery therapy in order to heal properly.
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