Revolutionizing Public Sector Arthroplasty: The Townsville Short-Stay Success Story
Day Surgery Arthroplasty
Introduction
Elective joint replacement surgery in the Australian public hospital system has traditionally been associated with long inpatient stays, averaging 5–6 days, followed by 7–10 days of inpatient rehabilitation. This model is costly, inefficient, and contributes to extended wait times for patients. With the projected rise in joint replacements—276% for knees and 208% for hips by 2030—and an annual cost forecast of AUD $5.32 billion, the need for innovation is urgent.
The Challenge
Public hospitals face systemic inefficiencies: delays in patient preparation, limited operating throughput, and resource constraints. These factors have historically made short-stay arthroplasty seem unattainable in the public setting.
The Innovation
Under the leadership of A/Prof Kaushik Hazratwala, Townsville University Hospital became the first public hospital in Australia to successfully implement a same-day discharge arthroplasty program. This groundbreaking initiative was delivered through a hybrid public-private model in partnership with Enovis, leveraging the Enovis 360 Short-Stay Pathway.
The program integrates:
- Rigorous patient selection using validated tools (OARA and RAPT scores)
- Pre-operative optimization with physiotherapy, medical review, and patient education
- Cutting-edge surgical techniques including robotic-assisted and computer-navigated arthroplasty
- Enhanced recovery protocols with opioid-sparing anesthesia and tele-rehabilitation support
The Results
Over a two-year period, 155 public patients underwent hip or knee arthroplasty through this pathway:
- Average hospital stay:16.2 hours (vs. 5–6 days nationally)
- 93% discharged within 48 hours
- 124 patients discharged within 24 hours
- 34 patients discharged same day
- Zero patients required inpatient rehabilitation
- Functional outcomes: Significant improvements in WOMAC scores, Sit-to-Stand, and Timed-Up-and-Go tests at 6 weeks (p < 0.001)
- Safety: Low complication rates (3% infection, 7.6% readmission), all managed successfully
Cost Savings and System Impact
This model delivers immense cost savings by reducing bed occupancy and eliminating inpatient rehabilitation, while maintainingexcellent clinical outcomes. It demonstrates that day-surgery arthroplasty is not only possible but highly effective in the public sector when supported by surgical expertise, advanced technology, and coordinated care.
Why This Matters
A/Prof Hazratwala is the only surgeon in Australia currently offering same-day hip and knee arthroplasty in a public hospital setting, setting a new benchmark for efficiency and patient-centered care. His leadership in robotic and computer-assisted surgery, combined with innovative care pathways, positions Townsville as a model for future public hospital reform.
If you are considering hip or knee replacement, discover how advanced techniques and enhanced recovery can transform your experience. Book a consultation with A/Prof Hazratwala today and explore the future of joint replacement.
