Same Day Knee Replacement

Ali Gorman, R.N. & Dawn Heefner

Lumberton, N.J. - December 18, 2008 (WPVI) --

Ted Marshall, 64, of Cherry Hill, N.J., has his grandchildren at his home nearly every day. And although this former physical education teacher bikes and swims, Ted's bad knees make it difficult tough to keep up. "It's become an embarrassment too. I go up and down stairs, I have to take one step at a time, I go down sideways," he said.
Still for years, he's put off knee replacement surgery until now. He's starting with the right knee.
And thanks to a new technique, Marshall won't have to spend a night in the hospital. Dr. Scott Schoifet of Virtua Memorial Hospital does a minimally-invasive technique for total knee replacement. It allows many patients to have surgery and go home the same day.

"I don't cut the quadriceps tendon," Dr. Schoifet said, adding that by leaving the tendon that connects the thigh muscle to the knee ligament intact, the patient can move better from day one. And some studies show the recovery time is two- to three- times faster than the traditional surgery. The new procedure also skips general anesthesia. It uses a spinal anesthetic to numb from the waste down. The patients wake up quicker and have fewer bad side effects.

After less than two hours in the operating room, Marshall is wheeled to recovery. And six hours later, Action News caught up with him for his second physical therapy session of the day.
While walking, Marshall said, "I feel a lot better than I expected to feel."

The physical therapists teach him how to get up and down stairs. Dr. Schoifet said he has to make sure patients will be safe at home in case there's an emergency. But he said recovering at home is already potentially safer because it lowers the risk for infection. "As much as I love hospitals, we have what we call nosocomial infections, we have MRSA, C-diff, all these things you just don't have in your house," he said.

Two weeks after the operation, Marshall is walking with little assistance. Dr. Schoifet said Marshall's recovery is a bit faster than most patients. He'll continue physical therapy, but is already cleared to drive. And within a few more weeks he'll be able to bike again and keep up with his grandkids. "The other one is starting to walk now too so with the two of them, I'm going to have to split directions so the mobility will be wonderful again," he said.

The newer technique may not be for everyone. Patients who are overweight, have had past surgery or are bow-legged may not be candidates. In order for patients to go home the same day, Dr. Schoifet said he looks for patients who are healthy, not on any medications and who are already physically fit.

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