Shaping up for surgery

Leg lifts, calf stretches and knee extensions, three times a day, before and after surgery, are part of the prescription that made Irene Ledsham’s recovery faster and easier.
 
After being referred to Alberta Hip and Knee Clinic Edmonton with a chronic knee problem, Ledsham was assessed for surgery and given a conditioning regime to prepare her for the operation.

“I just wanted to be able to walk the dog; to go down the stairs without hanging on; to be normal,” says the 73- year- old, who had chronic knee problems for years before undergoing a total knee replacement in October.  

Today, she can go for those walks without the excruciating knee pain.
“I hardly think about it now,” she says, laughing.

Ledsham is one of about 2,700 patients who had hip and knee surgery through Alberta Hip and Knee Clinic Edmonton in 2009. It provides a single point of entry to assess patients for surgery, as well as pre- and post-surgical joint care.  Similar clinics are run in Camrose, Red Deer and Calgary, which together have served about 5,500 patients last year.

Pre-surgery conditioning, available at all the clinics, is reducing the time it takes to return to normal routines.

Prior to the opening of the Edmonton clinic, the average length of stay in hospital following hip or knee surgeries was more than six days; with pre-conditioning and planning, patients are staying four days or less.

“The better shape patients are in going into surgery, the better their recovery.  Pre-conditioning definitely makes recovery faster and easier,” says Dr. Don Dick, orthopedic surgeon and clinic program director.

“With their preparation for surgery being much more intentional, (patients) have a better understanding of what will happen and how their recovery will go.”

Meanwhile, centralizing the intake of patients has reduced wait times to see the first available surgeon, from eight months prior to the clinic’s opening in 2006, to four months currently.

Each patient referred to the clinic is deemed surgical or non-surgical.  Non-surgical patients are provided a treatment plan and followed by the clinic. Surgical candidates are placed on a wait list and then optimized for surgery with the help of a multi-disciplinary team that includes a surgeon, nurse, dietitian, physiotherapists and occupational therapists.

This centralized model for referring patients has made a big difference.

“Patients are not falling through any cracks,” Dick says.

Operating room time is used more efficiently by managing all of the city’s hip and knee patients through one centralized system, adds Candace Kenyon, clinic director for the Edmonton Musculoskeletal Centre, which includes the hip and knee clinic.

“When an opening for surgery becomes available, we have prioritized the patients and can quickly fill those spots,” she says.

Most clinic patients are seniors like Ledsham, who says process is comfortable and easy to navigate.

“I wouldn’t be doing as well as I am today if it weren’t for the care I received at the clinic,” she says. 

“At the beginning I was scared, but the step by step help I got from the team made sure I knew exactly what to expect. The process was so complete, right from my preparation classes to my physiotherapy after surgery.”