Adrian’s one day knee replacement

A Worksop man has been one of the first to get a new knee and return home on the same day thanks to a team at Barlborough NHS Treatment Centre who have pioneered routine hip and knee replacement as day surgery.

Adrian Roke, 48, was in terrible pain caused by osteoarthritis. The condition eroded the cartilage and joints in both knees. His father has suffered from the same condition, having had his hip replaced at the same age.

Adrian explained: “The pain was really wearing: the knee would no longer fully bend, I didn’t sleep well and I had to give up circuit training and weight lifting.

“I have spent my professional life working as a maintenance engineer and I have won several awards. But three years ago I realised that, with my degeneration in my knees and the predisposition to osteoarthritis, I would not have many years of being able to carry on doing the work I love.

“I took the opportunity to retrain as a counsellor at Worksop College. I am the only man in the class, and I think it is important that men have the opportunity to have a male counsellor, if that makes them feel more comfortable and able to open up.”

Adrian’s GP referred him to Barlborough NHS Treatment Centre, which specialises in orthopaedic procedures. Lead orthopaedic surgeon Mr Gyorgy Lovasz said: “We like to delay full knee replacements for people in the 40s, as they will need more joint replacement in the future.

“Often a partial replacement is a good option, but in Mr Roke’s case the knee was too damaged and a full replacement was the only option.”

Over the last 12 months the centre’s clinical team has been developing techniques that allow full joint replacements to be carried out as day surgery. Medical director Marco La Malfa explained: “The technique uses spinal anaesthetic and an enhanced physiotherapy pathway, which enabled us to reduce the average stay for a hip replacement from four days in 2014 to an average of 2.3 days in 2017.

“The new day surgery pathway uses the same spinal anaesthetic, but no opiate-based drugs, meaning that while the operation is totally pain-free, the patient is able to get up and working with our physiotherapy team very quickly after returning to the ward.

“We perfected the technique and have carried out 26 hip joint replacements. Now we have developed a similar technique to be able to routinely offer one-day knee surgery. The technique is not for everyone. Age is irrelevant, but to undergo day joint replacement the patient needs to be otherwise healthy and have support at home.”

Adrian said: “It was fantastic: it all went very well and I was delighted that I had the opportunity to have surgery and be back home the same day. Everyone feels better recovering in their own home. I am also very happy not to have a general anaesthetic, as I have had them several times and did not like the after effects.

“Having met the team, I knew they were kind, professional and supportive. I was relaxed and confident about the surgery and looking forward to being pain free.”

Adrian is now successfully recovering and working well on his physiotherapy exercises.