Evidence-into-Practice Award Winners | Dr. Duncan Jacks & Dr. Jacques Smit

A patient bending their knee 10 minutes after a total knee replacement surgery.

A patient walking assisted with a walker, just 4 hours after a unicompartmental knee replacement surgery.

These astounding results from patients in the Victoria Enhanced Recovery Arthroplasty Program (VERA), a new approach to knee and hip surgery. Orthopedic surgeon Dr. Duncan Jacks and anaesthetist Dr. Jacques Smit developed the VERA protocol after witnessing a similar approach in Quebec.

For traditional joint replacement surgeries, patients receive local spinal anesthetic, which “freezes" patients below the waist. Pain, poor mobility, and common side effects like nausea keep patients in the recovery room. 

With VERA, patients are administered an epidural (“frozen" outside their spinal fluid) along with sedation. The full VERA protocol also includes advanced surgical techniques, with the use of different sutures and dressings. VERA patients report a higher satisfaction with their hospital experience. 

Patients have less postoperative pain and a shorter recovery period. 100% of VERA patients had no reported pain crises overnight following their surgery. Less pain for patients reduces the need for doctors to prescribe opioids for pain management.

Short hospital stays and reduced opioid consumption is significant for a health system that faces the dual health emergencies of the opioid crisis and the COVID-19 pandemic.

Island Health's Research and Capacity Building department was delighted to award Dr. Jacks and Dr. Smit the Bronze Award in the 2020 Evidence-into-Practice Awards.​​