Elizabeth Marsden, 64, couldn’t stand up straight before her partial knee replacement surgery. The pain in her knee meant she walked with an awkward gait and needed a walking stick to support her. Working on her son’s farm in New Mills, High Peak, was becoming a major issue due to her limited mobility.
As she was otherwise fit and well, she was offered the option of going home on the same day of her surgery and agreed, keen to be in the comfort of her own home as soon as possible.
“I’d definitely opt for day surgery again if I have the choice. I was at the hospital at 7am meeting my consultant Mr Lovasz for a pre-op chat and by 8.30pm I was home on the sofa recovering with my Jack Russell, Duchess! I was home in no time and able to fully relax and recover. I can’t thank the team enough. I feel I’m on my way to getting my life back on track!”
Recovering well from her surgery, Elizabeth is now planning to return for an op in her right knee later this year at the same hospital.
Same day joint surgery is extremely common in America and Canada, but is only available at some UK hospitals.
Elizabeth’s Barlborough team - Consultant Orthopaedic Surgeon, Gyorgy Lovasz, and Consultant Anaesthetist, Dr Marco La Malfa, were the first to establish a ‘same day’ practice in the Midlands and the hospital remains one of the most successful in same day surgery in the country.
It’s extremely common in America and Canada where they have surgical centres with no in-patient wards and everyone goes home on the same day. The Practice Plus Group, Barlborough, team learnt about the practice in America and introduced it to Barlborough in 2018
Studies show that patients who go home on the same day have better outcomes as they start moving sooner to get home and are more mobile in their own homes than in a hospital bed. This improves circulation and reduces the risk of DVT. The new joint feel more comfortable sooner because they are using it, and they manage pain better. Aside from the medical aspects there are the social aspects - they appreciate sleeping in their own bed and being with family.
The advantage for the NHS is that the hospital can help more people off NHS waiting lists as they have more capacity and available beds.
Mr Lovasz and Dr La Malfa have since published research on the outcome and safety of day case joint surgery.
Mr Lovasz, commenting on the study, says: “In addition to low re-admission and complication rates, day cases had very high satisfaction rates, with 98% of patients satisfied, showing that day case arthroplasty is a feasible, safe and highly satisfactory option for suitable patients.
“We can only offer this service to so many appropriate patients because of the strong teams we have. We all work together; the consultants, radiographers, nurses and physios, to provide the best possible care and support to the patient.”
Suitable patients tend to be the fitter, more straightforward cases - but not always. They also need to live not too far from the hospital, have someone at home, and easy access into their home. All of this is discussed in advance of the operation. Willingness is also a key factor - often patients really want to go home the same day. However, if after surgery a patient is not ready to return home then they are able to stay at the hospital until they are ready.
Practice Plus Group Hospital Barlborough is celebrating its 20th anniversary after opening in 2025. It continues to successfully help reduce NHS waiting lists in hip and knee surgery. Over the past two decades, the hospital has continued to grow with four theatres, and now over 5,000 private and NHS patients every year. The team specialises in hip and knee replacements, hernia treatments and cataract surgery. Private patients can be self-referred to Wellsoon Private Healthcare available at the hospital. NHS patients can ask their GP for a referral to Practice Plus Group Hospital, Barlborough.
Read full patient story: Elizabeth can stand tall again after knee surgery!
Before knee surgery Elizabeth Marsden, 64, couldn’t stand up straight. The pain in her knees meant she walked with an awkward gait which meant she hobbled around with a walking stick to support her. Working on her son’s farm in New Mills attending to chickens and rare breed cattle was becoming a major issue due to her limited mobility. After unsuccessful cortisone injections in both knees, she was referred for surgery at Practice Plus Group Hospital, Barlborough where waiting lists for NHS patients were the shortest in her region.
Recovering well from a partial left knee replacement, she’s now planning to return for an op in her right knee later this year at the same hospital. Elizabeth says:
I’d definitely opt for day surgery again if I have the choice. I was home in no time and able to fully relax and recover. I can’t thank the team enough. The whole experience has been phenomenal. I feel I’m on my way to getting my life back on track!”
“I was relieved to be finally referred for surgery as I’d got to the point where walking about and helping at our small holding, Lower Croft Farm, was a real struggle. I was walking with a stick and could barely stand up straight as my knees were bent in pain. I visited my GP and was sent to a Muscular Skeletal consultant for cortisone injections in both knees. Whilst these seemed to work for about two weeks, they soon wore off and the pain seemed worse than ever. When I mentioned this on the next visit, he said that I’d need surgery. He told me my quickest option was to be referred to Practice Plus Group Hospital, Barlborough, as it had the shortest NHS waits in the region.
“I was happy with this suggestion, despite the hospital being over an hour’s drive from home, as I wanted to be treated as soon as possible. My main goal was to be able to ride my horses again, which was a no-go due to the state of my knees.
“I was sent an invitation for a pre-op within a month, but had to cancel the appointment as it clashed with a farm show I’d committed to. The next appointment was sent through for the following month so I went along for a pre-med with my consultant Mr Lovasz. He confirmed that I was suitable for surgery as my knees were effectively ‘bone on bone’. He said the left knee was worst and would be operated on first.
“I took a cancellation appointment and was able to have my surgery at the hospital on the NHS all within four months of my referral. I was delighted by the speed and not having to wait. I’d heard other hospital’s NHS waiting lists could take months, so I was very lucky indeed. Coincidentally, my sister had had her knees done at Barlborough too and had been referred by her GP in Lincoln. We hadn’t realised that some private hospitals take NHS patients. It certainly sped up the treatment time.
“The best part is that I had my knee partially replaced in one day! I was at the hospital at 7am meeting my consultant Mr Lovasz for a pre-op chat and by 8.30pm I was home on the sofa recovering with my Jack Russell, Duchess! I also learned that I was the 1000th patient to have had a joint replaced in a day at the hospital and was surprised with a lovely hamper.
“The hospital was wonderful. All the staff were so friendly. The care at the hospital seemed far more personal that I’d ever experienced at my local hospital and I was treated with dignity and respect.
“I chose to have a spinal block for the op, which I’d been quite concerned about. I worried that as it was an injection in my spine there could be a risk. However, I needn’t have worried! I couldn’t feel a thing and my anaesthetist Marco, was fabulous.
“After an hour, I was in recovery and soon after was able to get out of bed and see the physio. I couldn’t believe how easy I was able to move about. After a quick x-ray the staff said I’d be able to go home and wouldn’t need to stay in overnight. It was a blessing to be able to go home to recover so soon. It’s a bit of mind over matter. I think going home sooner meant I just got on with my recovery and was not just sat about in bed. My friend stayed with me for a couple of days, though I felt perfectly ok and only took paracetamol for mild pain relief.
“Within a week the movement in my knee was fantastic. I could move it a 90-degree angle. What’s remarkable is I feel I’ve grown inches. I can now stand up straight again and people have even commented that they didn’t realise how tall I was.
“I’m hoping to get my right knee done later this year in Barlborough again. I just need to wait until the first one has recovered. I’m already excited by the thought that I could be riding again later in the year once both knees are good again. I’d definitely opt for day surgery again if I have the choice. I was home in no time and able to fully relax and recover. I can’t thank the team enough. The whole experience has been phenomenal. I feel I’m on my way to getting my life back on track!”