Last summer, Humber River Hospital started offering SKiP, a same day knee replacement program that uses a safe and highly effective nerve-block system to block pain sensation. Patients can usually return home the same day as their operation, and pain at the surgical site is blocked for three days using a continuous drip that runs from a bottle attached to a catheter in the patient’s thigh.

“Back when I did my surgical training, knee replacement surgery and recovery was very painful. We would have patients in the hospital for a week or more,” says Orthopaedic Surgeon Dr. Barry Cayen. “SKiP uses surgical techniques and advanced practices that allow us to numb the knee and provide continual pain relief for 72 hours. Patients can leave the hospital the same day to recover at home, with regular communication with their medical team.”

“SKiP is an elegant procedure because patients receive very little narcotics and have drastically reduced pain scores,” says Dr. Kyle Waldman. “When I think of surgery, I think of the “the mum test”. I ask myself if I would want my mum having this surgery here, and Humber is the only place I would want to send my loved one.”

SKiP patients don’t have to worry about pressing buttons or changing the nerve-block bottle. They simply leave it alone while they heal from surgery. Humber River Hospital provides a similar service – called COIN – to shoulder replacement patients.

“From my perspective as an Anaesthesiologist, SKiP is an elegant procedure because patients receive very little narcotics and have drastically reduced pain scores,” says Dr. Kyle Waldman. “When I think of surgery, I think of the “the mum test”. I ask myself if I would want my mum having this surgery here, and Humber is the only place I would want to send my loved one.”

During the pandemic, surgical procedures that decrease patient length of stay and minimize the use of post-operative pain medication are playing a vital role in Humber River Hospital’s ability to ramp up surgical services again, and they’re helping patients reduce their risk of exposure.

The SKiP Program has been a remarkable collaboration between our Surgery and Anaesthesiology teams, offering our patients the ability to recover comfortably at home.

Less time in the Hospital: Anita’s Story

“It was amazing I never really had any pain,” says Anita. “Even after I took the nerve-block catheter out I’ve been very pleased. I’m walking again, I’m driving again, and I’m really looking forward to golfing this summer!”

“In 1972 I was in a ski accident and tore all the ligaments around my knee,” remembers Anita. “My leg was never the same after that and over the years it got worse. In recent years, it became painful while walking. I knew something had to change.”

Anita met with Dr. Barry Cayen, an Orthopaedic Surgeon at Humber River Hospital who told her she would be eligible for SKiP. Anita had not wanted to stay at the Hospital during the pandemic, and was relieved to learn that she would be able to go home the same day as her operation.

“I was nervous because I’m 74 and it’s a major operation – especially during a pandemic,” said Anita. “But everyone was fantastic and that put me at ease. In the operating room, they even showed me the ROSA robot that would help them perform the surgery with more precision.”

Just hours after her operation, Anita was shocked that she was able to move and bend her knee with her Physiotherapist. Her friend arrived with her walker and she went home later that day.

“My Anaesthesiologist called me daily to see how I was doing and on the third day he walked me through removing the nerve-block catheter,” says Anita. “It was amazing I never really had any pain. Even after I took the catheter out I’ve been very, very pleased. I’m walking again, I’m driving again, and I’m really looking forward to golfing this summer!”

Less need for general anaesthetic and post-operation opioids: Barbara’s Story

“Twelve years ago I had my right knee replaced and did not cope very well with the general anaestheic,” remembers Barbara. “It took me days to recuperate. So when I found out I needed surgery on my left knee I was really frightened about having to go through that recovery again.”

Barbara was relieved when her Anaesthesiologist Dr. Kyle Waldman explained that for her SKiP procedure, he would use a nerve-block bottle to stop pain to her knee. The bottle would replace the need for general anaesthetic and continue to block her pain continuously for days after her procedure.

“Going into my operation I was in great spirits,” says Barbara. “I have known my surgeon Dr. Martin Heller for a very long time, and Dr. Waldman made me feel so confident about managing the pain. They made a great team.”

After Barbara went home, she was pleased to hear from Dr. Waldman daily.

“He wanted to check on my bottle to make sure there was enough inside,” she says. “On the last day he directed me on the phone on how to take it out. Since my operation, there was only one time I had to take a painkiller. It has been a month and I can fully bend my knee. I feel great. If I ever needed another surgery at Humber I would feel really confident.”