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Johns Hopkins Bayview News - A Hop, Skip and a Jump

Winter 2016

A Hop, Skip and a Jump

By: Martin Fisher
Date: February 1, 2016

Advances in joint replacement surgery allow same-day discharge


Harpal “Paul” Khanuja, M.D., showing a model of a knee joint
Harpal “Paul” Khanuja, M.D., is part of a team working to get patients back home more quickly after orthopaedic surgery.

There’s a profound sense of relief after any successful operation, including joint replacements. Unfortunately, for many patients that relief quickly turns to boredom as they wait to be discharged from the hospital and sent home. Advances in surgery and pain management now mean that many orthopaedic surgery patients at Johns Hopkins Bayview Medical Center have the option to go home the very same day.

It was an easy choice for Marilyn Averi. The 61-year-old had her right knee replaced in March. When Harpal “Paul” Khanuja, M.D., chief of adult reconstruction for hip and knee replacement, suggested letting her go home after they replaced her left knee, she laughs as she recalls, “I said, ‘Sure!’ I knew how it had been staying overnight in the hospital, and I appreciated being home.”

Orthopaedic surgery is extremely compli- cated, but many improvements have contributed to a much more pleasant experience for patients, says Dr. Khanuja. “We have a dedicated multidisciplinary team for joint replacements, and we’ve done so well improving outcomes with surgical techniques,” including new monitoring techniques during surgery that reduce blood transfusion rates to near zero percent.

As a result, patients have more energy immediately after surgery. “We also changed how we manage their pain, which is so well-controlled they don’t even need an intravenous drip,” says Dr. Khanuja. Patients can start walking hours after a joint replacement. The goal, he explains, is to get patients “as healthy as possible as quickly as possible. You sleep better at home, and you eat better at home.” Not every patient will be able to go home early, and the team is also happy to accommodate patients who would prefer to stay at the hospital during their recovery.

Averi was impressed with the speed and precision of the orthopaedic team at Johns Hopkins Bayview. “It was very smooth, and it was a good experience. I highly recommend Dr. Khanuja and the entire staff, from the anesthesiologist to the nurses. Everything was just top-notch.” She hopes she won’t need another joint replacement, but she says, “If I had another one done, I’d get it done here.”

To learn more about orthopaedic surgery or make an appointment, call 443-997-BONE (2663).