A knee replacement and back home the same day

Paul Guimond had his left knee replaced several years ago and spent two nights at the Alfond Center for Health before being discharged.

In January 2021, the 67-year-old Winthrop retiree had his right knee replaced. But this time, it was done as an outpatient procedure through MaineGeneral’s same-day joint replacement surgery program. Guimond’s surgery started at 8 a.m. and he was back home by noon – and very impressed with the experience!

“It went really well,” Guimond said. “They got me right up and got me going, and I had the pain block in my leg which made a big difference at home. I made sure to let everyone at the hospital know before I left just how grateful I was and how much I appreciated everything they did.”

Guimond had one home health therapy visit after surgery and one outpatient physical therapy session. Then he resumed his active lifestyle that includes many hobbies and interests, like building street rods from the ground up, something he’s enjoyed doing since he was 18 years old.

“I’m a welder, fabricator, machinist, mechanic – I do everything,” he said. “I can’t sit still and I’m always moving.”

Guimond said the physical work he’s done all his life likely contributed greatly to the osteoarthritis that eventually led to his surgeries.

“I do a lot of manual labor. I work in the woods and I’m a mechanic, so I’ve had a lot of wear and tear over the years,” he said, adding that he held off scheduling his second knee replacement until the pain became unbearable.

“Eventually it got to where I had a hard time walking from my house to the garage and back without it being very painful. That’s when I said, ‘Enough is enough!’”

Now fully healed and pain-free, Guimond’s full attention has returned to his automotive creations and other fabrications.

Recently contacted for an update on his activity level nine months after surgery, Guimond said his recovery has gone so well that he had forgotten he even had surgery.

“The good news is that I totally forgot that I had a knee replacement,” he said, adding that he has returned to his active lifestyle in full force.

“Lately, I’ve been cutting lots of firewood and I’ve also built a few more vehicles,” he said, adding that he also created a very large metal Despicable Me minion for his granddaughter. “Things are going quite well.”

An option with many patient benefits

MaineGeneral’s same-day joint replacement surgery program is a collaborative effort among MaineGeneral Orthopaedics, anesthesiology staff, PACU/Day Surgery, home health and outpatient therapy. It has had many patients like Guimond returning home the same day – with great results!

Plans to offer outpatient total joint surgery started about three years ago when orthopaedic surgeon
David Wexler, MD, FRCS, and Jenee Wechsler, ACNP, who assists him in the operating room and provides pre- and post-operative patient care, attended a conference and learned what was needed to make it work.

They and other MaineGeneral Orthopaedics’ surgeons and staff did some preliminary work but developed the program fully when COVID-19 halted elective surgeries for a period of time.

Wechsler said her past nursing experience was extremely helpful in identifying the elements and players needed to make the program successful.

“I had a very good understanding of how things flowed, which helped me put things together,” she said, noting that surgeons Wexler, Mike Rodger, MD, FRCS and Stuart Aitken, MD, FRCS, have really championed the effort.

To further develop the program, MaineGeneral Orthopaedics welcomed Christine Booker, RN, as orthopaedics nurse navigator. She helps patients before and after surgery, and follows up with them after they return home. She also ensures they have what they need, which includes such things as medical equipment and home health and outpatient therapy.

Wexler says there are many benefits for patients.

“The biggest is that there’s no place like home,” he said. “There’s less risk of infection, they can sleep in their own beds and stay with their families. And if a patient has to stay at the hospital longer, that’s an option for them.”

Wechsler says the patient response has been overwhelmingly positive.

“They’re very happy to go home and they’re surprised at how well they do,” she said. “That’s a credit to the many staff involved from start to finish. It takes a team effort to make sure this goes really well.”

Learn more about same-day joint replacement surgery at www.mainegeneral.org/ortho, where you can watch an educational video from the doctors who perform the surgery and also view their video profiles.