Malaysia Marks Milestone With First Daycare Same-Day Discharge Hip Replacement Surgery

The procedure was carried out at Universiti Malaya Medical Centre (UMMC) on May 7, 2025, and the patient was a 72-year-old woman who was discharged on the very same day and has since made a smooth recovery.

Consultant arthroplasty surgeon at UMMC’s Department of Orthopaedic Surgery Dr Veenesh Selvaratnam told Bernama in an interview that this achievement demonstrates Malaysia’s orthopaedic surgical care is now on par with advanced nations such as the United States, the United Kingdom and Canada.

“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. Therefore, this success further strengthens public confidence in the quality of our nation’s healthcare system,” he said.

Following the success of this first case, UMMC has scheduled several daycare THR procedures for December 2025 and January 2026.

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. Most importantly, it sends a clear message that Malaysia is poised to continue advancing in medical innovation as well as strengthen its position as a regional healthcare hub.

 

Dr Veenesh said UMMC’s ability to carry out daycare THR lies in the hospital’s expertise and advanced technology.

“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,” he said.

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 7.30 am, with surgery starting around 8.30 am. 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, who preferred to be known as Madam Yap, is a retired secondary school teacher from Petaling Jaya. She had endured more than a year of hip pain that severely limited her mobility. After learning about the hospital’s daycare total hip replacement option during a consultation, she immediately agreed to be the first patient to undergo the procedure. She also said she felt more comfortable recovering at home with her family.

Remarkably, just four hours after the 90-minute operation, she was already able to walk almost pain-free. She said her experience offered hope to others that it is possible to return to normal life sooner than expected.

Dr Veenesh emphasised that the success of the operation was the result of a multidisciplinary approach involving assessments by anaesthesiologists, physiotherapists and surgeons.

 

Commenting on the anaesthesia approach, UMMC consultant anaesthesiologist and pain management specialist Dr Lui Ken-Yi said it must be tailored for daycare THR surgery.

“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.

According to Dr Lui, 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 explained, 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.

 

While the approach offers many benefits, Dr Veenesh acknowledged that its implementation faces challenges, particularly the low level of public awareness regarding the safety and effectiveness of daycare THR surgery.

“Many patients still believe that major operations such as joint replacements require several days of hospitalisation. This calls for a shift in mindset and greater confidence in the healthcare system,” he said.

In this context, effective communication and patient education play a critical role. Comprehensive pre-surgical preparation, including detailed briefings and post-operative care simulations at home, helps build trust in daycare THR.

“The equipment and materials used in these procedures are the same as those used for conventional total hip replacement surgeries. There is no compromise in quality or treatment standards. The key implants — including the socket (acetabulum), femoral stem and femoral head — are made from high-quality materials that are recognised globally in the orthopaedic field,” he added.

Materials such as titanium are used for their light weight, corrosion resistance and biocompatibility, making them ideal for the human body. Other materials used are stainless steel, which provides high mechanical strength and durability under daily stress; and ceramic, which is used for joint surfaces due to its smoothness and wear resistance. It also reduces friction and extends the lifespan of the implant.

The careful selection of these materials ensures optimal joint function, long-term comfort, and reduced risk of complications such as loosening or premature wear. Thus, even with same-day discharge, safety, efficacy, and quality remain uncompromised.

 

The introduction of daycare THR surgery also opens new opportunities in Malaysia’s medical tourism sector. The country can now position itself as a preferred destination for modern, safe and effective orthopaedic treatments.

According to Dr Veenesh, the facilities used for this surgery are also shared with the private sector through UMMC’s collaboration with Universiti Malaya Specialist Centre (UMSC). The same medical team and surgical facilities are involved, which helps reassure international patients about the quality of care offered.

“However, ethical promotion and clear communication to international markets are essential to ensure the unique advantages of this approach are properly understood. The success of early implementation (of daycare THR) at local institutions can serve as a strong testimonial to build trust among patients from abroad.

“With close collaboration between the public and private sectors, along with supportive national health policies, treatment models like this have the potential to establish Malaysia as a competitive and sustainable regional hub for health tourism,” he added.