Outpatient Hip or Knee Replacement

Is a short-stay hip or knee replacement right for you?

Outpatient hip or knee replacement surgery, also known as total joint arthroplasty (TJA), is now being performed in select centers on select patients who are healthy enough to be candidates for this pathway. These surgeries can be done at an ambulatory surgery center or an inpatient hospital. Orthopedic surgeons agree that outpatient TJA should only be done on patients who are healthy enough to have surgery in such a setting and have the appropriate home setting/support to allow them to be discharged in this manner. This concept is new, and orthopedic surgeons are still clarifying how to maximize the benefits of this idea for patients.

Know your health care team.

The entire health care team for an outpatient TJA must be adept at managing this type of surgical pathway.

Your primary care provider
Needs to agree that you are medically able to tolerate the surgery.

Your orthopaedic surgeon
Deems that you are a candidate for outpatient TJA and feel comfortable doing the surgery in this manner.

Your anesthesiologists
Skilled at multimodal pain management techniques to ensure your safety, pain management and quick recovery.

Your nursing team
Skilled at preoperative education, operating room workflow, rapid recovery, and be able to assess your readiness for discharge.

Your family or friends
Educated about what to expect at home and about recognizing potential postoperative complications. Furthermore, an open line of communication with your healthcare team and providers must be established pre-operatively to relay information regarding your condition when you are home.

Advantages and Disadvantages

The advantages of outpatient TJA include a reduced hospital stay, a possible reduced chance for hospital acquired infections, and the possibility of increased patient satisfaction. There is also potential for reduced cost to the health care system.

The disadvantages of the outpatient TJA include the chance of having a complication at home, having difficulty with pain management, and the chance for readmission to the hospital.

Orthopaedic surgeons agree that outpatient TJA is not for everyone, and actual peer-reviewed reports on the success of this approach are few with varied but usually positive results. Interest in the role for outpatient TJA will most likely increase over time.