PETALING JAYA: Malaysia saw a breakthrough in healthcare services when the nation’s first-ever daycare total hip replacement (THR) was performed, a landmark moment in the field of orthopaedic surgery.
The 72-year-old patient was discharged on the very same day after the procedure on May 7 and has since made a smooth recovery.
This achievement demonstrates that Malaysia’s orthopaedic surgical care is now on par with advanced nations such as the United States, the United Kingdom and Canada, said consultant arthroplasty surgeon Dr Veenesh Selvaratnam of Universiti Malaya Medical Centre (UMMC)’s Department of Orthopaedic Surgery.
“Developed countries have long practised this (daycare) approach, but in Malaysia, we (normally) perform the conventional method that requires patients to remain in the hospital before and after surgery,” he told Bernama.
Although still in its early phase, the daycare THR initiative signals a major step toward expanding modern treatment models that emphasise early recovery, patient safety and more efficient use of public healthcare resources.
“The conventional method requires patients to be admitted before surgery to enable them to undergo several screening tests and assessments. However, with the expertise we now possess, these evaluation and screening processes can be shortened,” said Dr Veenesh.
Patients considering same-day discharge after total hip replacement must undergo thorough screening to confirm their eligibility.
According to Dr Veenesh, only patients deemed truly fit in terms of health and home support are considered for daycare treatment.
Other key considerations include stability of their chronic conditions, such as diabetes and hypertension, and ensuring they have a caregiver at home and their residences are not too far from the hospital.
In this first case, the patient arrived at the hospital at 7.30am, with surgery starting around 8.30am. Post-surgery, she was placed under close clinical observation, where the medical team carefully monitored her blood pressure, consciousness level and the effects of anaesthesia, and pain management to ensure she met the criteria for discharge by late afternoon.
The patient, identified as Madam Yap, is a retired teacher from Petaling Jaya. She had endured more than a year of hip pain that severely limited her mobility.
Just four hours after the 90-minute operation, she was able to walk almost pain-free.
Dr Veenesh emphasised that the success of the operation was the result of a multidisciplinary approach involving assessments by anaesthesiologists, physiotherapists and surgeons.
UMMC consultant anaesthesiologist and pain management specialist Dr Lui Ken-Yi said:
“The use of spinal anaesthesia, combined with local anaesthesia techniques such as PENG (pericapsular nerve group) can accelerate recovery while effectively managing pain without causing nausea or delayed consciousness after surgery.
“In addition, pre-surgical screening should include thorough briefings for both patients and their families to ensure they understand their responsibilities and the warning signs of potential complications. This approach reduces post-surgical risks while ensuring safety levels equivalent to conventional surgery,” he said.
Dr Lui said the daycare THR procedure was introduced after observing that many patients prefer to leave the hospital as soon as possible, particularly those with manageable pain and strong home-care support.
“This not only speeds up recovery but also reduces the risk of infections commonly associated with hospital stays,” he said, adding that before discharge, THR patients are assessed by the physiotherapy team to ensure they can sit, stand and walk.
“If they can perform these basic movements safely and with stability, they are considered fit to go home on the same day,” he said, stressing that patients who do not meet the criteria will remain hospitalised.
From a healthcare system perspective, Dr Lui noted that such an approach saves time and resources, enabling more patients to be treated in shorter periods, thereby easing waiting lists and reducing pressure on hospital beds and clinical staff.
