The increasing rates of COVID-19 due to the second wave has led to increasing patient admissions into The Princess Alexandra Hospital. Due to the loss of resources as a direct result of this, and along with the increasing ‘winter pressures’, it has affected our ability to provide routine elective surgery. The trust is reviewing the situation on a weekly basis but for the past three weeks, no elective in-patient orthopaedic surgery has taken place. Day surgery operations are still being performed on a selective basis. Please be aware that all emergency operations (e.g. fractures, infected joints) are still being performed.

Mr Kosuge is working with the hospital to look at ways to re-establish elective in-patient operating in a manner that meets the safety criteria required. It has been a challenge with regional COVID-19 rates increasing rather than falling. Rates of COVID-19 in many areas of Essex are now higher than the national average - e.g. Harlow 234.3 per 100 000 and England 156.2 per 100 000 in the week to 6th December 2020.

It was reassuring to see the COVID-19 vaccination programme roll-out last week. However, Mr Kosuge advises you to continue to remain vigilant and to adhere to the government rules pertaining to COVID-19. The NHS has published information about the vaccine.

The British Orthopaedic Association published their latest statement regarding elective activity, waiting lists and restarting. For patients waiting for a hip or knee replacement, please visit Joint School for helpful information, exercises and tools to help.

Source: Gov.uk

A patient of Mr Kosuge recently underwent a knee replacement and was successfully discharged from hospital the day after his procedure. Please see a video* of his progress as an in-patient at Rivers Hospital.

Early discharge from hospital following total joint replacement surgery has started to gain acceptance. Prolonged stay in hospital can increase risks of hospital-acquired complications and with the COVID-19 pandemic, there is a further reason to encourage early rehabilitation and discharge from the hospital environment.

In select patients with the correct education and support, along with a dedicated surgical, anaesthetic and rehabilitation team, it is very possible to get patients home early. The average length of stay in UK hospitals is between 3 to 5 days but Mr Kosuge is working with his patients and team to reduce this. It is no longer uncommon for patients to be discharged from hospital the day after their hip or knee replacements.

It is important for patients to understand that on-going support is present, in the form of rehabilitation that continues on an out-patient basis. Patients are reviewed regularly by the physiotherapy team after discharge from hospital. In addition, there is a mechanism by which patients can contact the ward for advice or queries.

*Patient consent was obtained for publication of this video.