Outpatient Total Joint Replacement

Total hip and total knee replacements are some of the most successful procedures performed by orthopaedic surgeons. Although traditionally thought of as an inpatient surgery (requiring a hospital stay), innovations in anesthesia, improvements in surgical techniques and the development of new protocols for managing post-operative pain now allow replacement surgery to be safely performed in the outpatient setting.

The goal of joint replacement is to provide you with a durable and well-functioning joint while minimizing complications. Once you have made the decision to have replacement surgery, your doctor will discuss whether or not outpatient surgery is suitable for you. One important consideration is your overall health status - outpatient joint replacement is most appropriate for healthy individuals without serious medical conditions.

Another essential element is adequate home support. Family members or friends must be available and comfortable with caring for you at home. Instructional materials are provided that include a step-by-step description of the procedure and what to expect before, during and after surgery. An educational class for the patient and family members offers additional information and another opportunity for you to ask questions. The nursing staff will explain the details of wound care and how to identify problems.

Several measures are used for controlling pain after surgery. Preoperative medications, both oral and intravenous, are administered to help with postoperative pain. The anesthesiologist can perform a nerve block to decrease pain. During surgery, long-acting local anesthetics can be injected to numb the soft tissues around the joint. This multimodal approach is designed to keep you comfortable at home and reduce the need for narcotic medications that have serious side effects such as sedation, nausea and constipation.

When your surgery has been completed, the physical therapy staff will assist you to stand and walk, to climb stairs and use the restroom. They will also work with your family members on activities of daily living. When all goals are met you are discharged to home, usually 3 to 4 hours after surgery. During the first week, a physical therapist will come to your home to continue your rehab program.

The transition of joint replacement surgery to the outpatient setting allows patients to recover in the comfort of their own home. The advantages include a reduced chance for hospital-acquired infections, fewer complications and an increase in patient satisfaction with their experience. More information on hip and knee replacement surgery is available in our Patient Education section.

Dr. Mary Albert M.D.