Move and handle 30 kilo bags of mortar. It is the daily bread of Richard Labbé, a 65-year-old mason. In mid-July, he had to undergo hip replacement surgery, which was causing him pain both at work and at home. “I entered the hospital at 6.30 am and at 5 pm I was home! Said the entrepreneur from Beauharnois.
Richard Labbé is one of the first patients to undergo total hip replacement in day surgery at Anna-Laberge Hospital in Châteauguay. The very day of his surgery, he climbed the 20 steps of the staircase leading to his accommodation located on the second floor of the building where his workshop and that of his cabinetmaker brother are located.
“At the hospital, I was made to climb four or five steps, four or five times [pour m’exercer] », Explains the man with gray-white hair, agile and solid on his legs. “I was a bit on the fumes. It helped get me up the stairs! His wife was by his side.
For the past four months, Anna-Laberge Hospital has offered total hip replacement in day surgery – an intervention developed in 2016 by Dr.r Pascal André Vendittoli, orthopedic surgeon at Maisonneuve-Rosemont hospital. So far, eight patients have benefited from it. The hospital center has also been performing knee replacements for a one-day operation since December 2018.
The Suroît hospital, in Salaberry-de-Valleyfield, has just followed suit. Two hip surgeries were performed this summer; a knee replacement too.
Thanks to these interventions, the CISSS de la Montérégie-Ouest wishes to promote the rapid recovery of patients, but also to reduce waiting lists for surgery and hospitalizations.
At the Suroît hospital, 1,537 patients were awaiting orthopedic surgery on August 20, according to Luce Lebœuf, head nurse of the operating room. “Currently, I have reached a waiting period of two years, two and a half years,” she laments. The ideal would be six months. “
During the summer season, the Suroît operating theater ran at 50% of its capacity due to the staff shortage, she said. “I will be able, in the fall, to go back to 75%, but I will be unable to be at 100%,” says Mme Lebœuf.
Too many nurses and respiratory therapists are missing in the operating room and on the floors where patients are hospitalized after surgery. Beds have also been closed, which has an impact on the emergency. The occupancy rate in Suroît was 178% Tuesday afternoon, with 27 patients on stretcher for 48 hours.
Not a quick fix
Day surgery joint replacements won’t solve everything. Not all patients can access it.
Age, weight and comorbidities are taken into account when selecting candidates, points out Claudine Ricard, head nurse of the operating room at Anna-Laberge hospital. “A patient with a BMI [indice de masse corporelle] at 50, you can’t accept it, she cites as an example. If patients have uncontrolled sleep apnea, have uncontrolled diabetes or high blood pressure, they are unfortunately excluded. “
Patients with these conditions need monitoring and medical attention for a few days in the hospital following joint replacement. The protocols for “traditional” surgery and for day surgery differ (see box).
“What we don’t want is that at 2 am, things aren’t going well and the patient has to come to the emergency room by ambulance,” says Dr.re Lynne Dumais, anesthesiologist at the Suroît hospital.
The two hospitals want to increase these interventions in the future. “But it is certain that we will always have a limitation in the medium term and in the short term,” says Claudine Ricard. We can’t do two, then three, then four a day, because that has an impact in rehabilitation. “
Physiotherapy professionals, who provide follow-up, are rare in Suroît, according to Karine Cervera, head of rehabilitation service at the CISSS de la Montérégie-Ouest. “I am missing almost half of my staff,” she said.
Despite the obstacles, the Dr Eric Hylands, orthopedic surgeon at Suroît hospital, is delighted to be able to offer this operation to certain patients. “I have patients who have not worked for a year and a half, two years, says Dr.r Eric Hylands. Patients who no longer do any activity, who no longer have fun in life. It even goes as far as psychological distress. I have patients who have spoken of suicide. All the ramifications of orthopedic wait times right now, it’s a tragedy. “
Richard Labbé, he measures his luck. It was only five months between her consultation with an orthopedic surgeon and her day surgery. He recovered quickly after the operation and now goes about his business without a cane, except sometimes in the evening. “I’m still walking a bit like a robot,” notes the mason. The secret is physio, an hour or two a day. “
Richard Labbé is motivated. He wants to get back to working full time, playing golf and getting back on his bike. Retirement will come later.