Alan Creaner, a man in his 60s, recently became the 300th patient to undergo joint replacement surgery and return home the same day under the Same-day Surgery and Discharge programme at the National Orthopaedic Hospital Cappagh (NOHC).
Having previously had his first hip replacement abroad under the Treatment Abroad Scheme, Alan described the contrast between his overseas experience and Cappagh as “night and day.” He said: “I couldn’t believe the difference the care, the efficiency, and the comfort of being back in my own home that evening.”
His recent surgery was carried out by Mr James Cashman, supported by Dr Brid McGrath, Consultant Anaesthesiologist, and the hospital’s dedicated Same-day Surgery and Discharge team. The programme sees suitable patients admitted early in the morning, undergoing total hip or knee replacement, and safely discharged that evening, significantly improving recovery times and reducing hospital stays.
“These patients return home with excellent pain relief, having met all physiotherapy discharge goals, and are well supported by our nursing and rehab teams,” said Mr Cashman.
NOHC became the first Irish public hospital to perform a day-case hip replacement in 2018, with the first same-day knee replacement completed in December 2022. Mr Cashman introduced the Same-day Surgery and Discharge programme, which has since expanded with participation from consultants Prof. John O’Byrne, Mr Conor Hurson, and Mr Adrian Cassar Gheiti to include total and partial knee replacements.
The programme is offered to patients who are otherwise medically fit and have strong home support. In 2024, the national average hospital stay for hip replacement was 2.7 days, and 3.4 days for knee replacement. The Cappagh programme reduces this to under 12 hours.
Patients treated to date range in age from 32 to 75 for hip replacements and 50 to 67 for knees, with 63% of surgeries performed on male patients. A number of early patients have already returned for second-side procedures, including some same-day partial knee replacements.
The first total hip replacement in Ireland took place at Cappagh in 1969, when a hospital stay of up to six to eight weeks was standard, including two weeks in isolation ahead of the procedure. Today, patients can safely walk out the same day.
Since that time, NOHC has performed more than 50,000 hip and knee replacements, treating over 30,000 patients annually at its west Dublin campus. The hospital now performs around 1,000 hip replacements a year, a significant portion of Ireland’s national total of 4,500 annually.
“The safety and efficiency of the Same-day Surgery and Discharge programme has revolutionised how we deliver orthopaedic care,” said Mr Cashman.
“This 300-case milestone is a credit to the entire team and reflects what’s possible in Irish healthcare when we design services around patients, not waiting lists.” Angela Lee (pic), CEO of NOHC, said the programme has received consistently positive feedback.
“This is multidisciplinary care at its best, from pre-operative planning to post-op recovery. I want to commend the surgeons, anaesthetists, nurses, and physios who make this possible.” She added that while the reduction in hospital stays offers significant benefits, greater capacity is still urgently needed.
“Our population over 65 is growing faster than almost anywhere in Europe. That means rising demand for orthopaedic surgery.
“While we’re proud to lead on innovation, we’re also advancing plans to expand hospital capacity so we can treat more patients, more efficiently, across the country.”
