Day-case or out-patient joint replacement surgery is defined as patient discharge on the same day of surgery. The advantage of day-case joint replacement surgery for patients is in the ability to recover and rehabilitate in the familiar surroundings of their own home. The shorter stay in hospital also limits the unnecessary exposure of patients with hospital staff and other patients, potentially reducing risks of complications.

Mr Kosuge was part of the multi-disciplinary team that devised day-case hip and knee replacement pathways at Rivers Hospital. Whilst not appropriate for all, it has been shown to be safe and effective in carefully selected patients. Over the past few months, Mr Kosuge has successfully performed day-case hip replacements on patients who fulfil the criteria and feedback from patients have been very positive:

‘I have had two total hip replacement procedures under the care of Mr Dennis Kosuge and the latter one carried out in April 2021 allowed me to return home on the evening of the operation, this is surely a remarkable achievement by any standards. The skills required to create such oustanding results are second to none and I cannot thank Dennis enough for the changes he has made to my mobility and life style.’

• Are you motivated and willing to participate?

• Have you got appropriate support at home?

• Are you fit and healthy from the medical point of view (e.g. no significant heart or lung disease)?

You may be appropriate for day-case hip or knee replacement surgery if your answers to the above questions are all ‘Yes'. For further information, please do not hesitate to book a consultation with Mr Kosuge at Rivers Hospital in Sawbridgeworth.

There is increasing interest in eliciting feedback from patients to highlight aspects of care for improvement and to monitor performance and quality of care. Patient experience questionnaires (PEQs) and patient reported outcome measures (PROMs) questionnaires are being increasingly utilised to monitor the performance of an organisation, or even an individual clinician. Whilst it is still not common practice for individual clinicians to do so, Mr Kosuge invests much of his time in ensuring collecting PEQs and PROMs is part of his clinical practice.

Mr Kosuge has collected both PEQs and PROMs data from his patients since being appointed consultant in 2015. This data is analysed and reviewed regularly by Mr Kosuge. Updated data is now available on ‘Mr Kosuge’s Outcomes’ and he is pleased to see that the data continues to demonstrate high levels of patient satisfaction in the majority of cases. Below is feedback from a patient who recently underwent a hip replacement by Mr Kosuge:

‘From the outset, and throughout the pre-procedure consultations, Mr Kosuge exhibited the highest standards of professionalism. He demonstrated a warmth of character and presented a clear analytical appraisal of my symptoms explaining how the replacement of my current arthritic hip should lead to a markedly improved mobility and, therefore, life style. Prior to the surgery, just before going into theatre, his continuing conversations with me further endorsed my total confidence in his expertise, a situation which enabled me to feel fully relaxed. The total absence of pain (now) from the hip post surgery is remarkable and has to be a reflection of Mr Kosuge's surgical skills. My improved mobility is currently at a level that I have not experienced for at least 5 years and it should continue to improve as I gather further strength in my legs after having had a very sedentary existence for some time. I am most grateful to Mr Kosuge for his surgical skills and it was a pleasure to meet such a friendly and well-spoken surgeon.’

For more patient feedback, please visit iWantGreatCare.