‘Everything is easier’: Life one year after same-day hip surgery

By Ana Gajic

Five years after quitting hockey due to a painful hip, 61-year-old Tim Heenan is back on the ice every Tuesday night.

One year ago, Heenan received a hip transplant at St. Michael’s Hospital and was discharged the same day. He was one of a first cohort of patients to undergo a novel surgery, which allows people to receive a hip replacement surgery and return home within 12 hours.

Heenan’s experience with this new procedure made headlines across Canada, but for him it offered the opportunity to recover quickly and in a comfortable environment.

“It was great to get home right away,” he said. “A few days later, we were up north at the family cottage and I was recovering there – it couldn’t have been better.”

Within four weeks, Heenan was back at work as a construction worker in his hometown of Innisfil, Ont. He found tasks that had previously caused excruciating hip pain were now much easier to perform. Ten weeks after that, he was playing tennis with his son – “very gently,” he added.

Dr. Amir Khoshbin, Heenan’s surgeon in the Division of Orthopedic Surgery, began performing same-day hip replacement procedures at St. Michael’s in early 2018. Dr. Khoshbin, with the help of a multidisciplinary team to roll out this novel procedure, spearheaded what he calls a “culture change” for patients and the hospital.

“For patients we discharge on the same day, our pain protocol and processes were changed through a collaborative effort,” he said. He points to the collaboration between anesthesia, nursing, physiotherapy, case managers, pharmacy, clinical leader managers, and occupational therapy as the reason for the procedure’s success.

Two other surgeons (Dr. Amit Atrey and Dr. Sarah Ward) at St. Michael’s have started to offer the same-day discharge option for hip replacement surgery. So far, the three have performed more than 60 same-day discharge hip replacements as of March 2019.

“In the right patient population, with the right support team – which we have here at St. Michael’s – this is a great option,” Dr. Khoshbin said.

The orthopedic team screens patients who might be eligible for same-day hip surgery at their initial consult and also at their pre-surgery anesthesia consult. Those who have obstructive sleep apnea, diabetes, chronic obstructive pulmonary disease, or who use or require any kind of monitor, atrial fibrillation or strong blood thinners are generally not good candidates for the same-day hip surgery.

Dr. Khoshbin and his team have also consulted with other hospitals in Toronto who are interested in this procedure. The feedback from staff and patients so far has been overwhelmingly positive, Dr. Khoshbin said.

Heenan is thrilled to be living without the pain in his hip that was previously constant and often debilitating.

“I’m like a kid again: running, playing tennis and going into the corner like a bull on the ice,” he said with a laugh.

“Truly, the St. Michael’s team has been fantastic – everything is easier for me now.”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.