Are Outpatient Total Joint Replacements the Way of the Future?
If you had a joint replacement about 10 or so years ago, you may remember a long extended stay in the hospital following the procedure. It was not uncommon for patients to stay up to a week in a hospital setting. Many patients then also went to a nursing home following their hospital stay. We have learned a lot about post operative recovery from joint replacement surgery in the last decade. Our techniques have advanced so much that it is entirely possible to go home the very same day of your surgery.
The orthopedic community was moving towards the idea of outpatient total joint replacements in the last several years, but the Covid-19 pandemic really kicked this into high gear. When the pandemic hit elective surgeries shut down for several months. Once these orthopedic surgeries resumed, total joint replacement surgeries were only allowed to be performed on low risk patients who would be able to go home the same day of surgery. This thought process was based on the limited availability of hospital beds and high volume of Covid patients. We realized after switching solely to outpatient surgeries that patients did quite well. We were able to come to the conclusion that the majority of our patients don’t actually require a Hospital stay following joint replacement surgery.
Advantages to Outpatient Joint Replacement Surgery
Early mobilization has been found to be key in speeding up recovery and reducing risk of complications like blood clots. At home you are able to move around as much as you like without setting off a hospital bed alarm. (For safety purposes make sure someone is with you while ambulatory initially).
One of the modalities that has helped patients recover at home has been the addition of a long acting nerve block. This is typically performed the morning of the surgery by a skilled anesthesiologist. They will inject a long acting medication that can numb the area for a few days. This can help greatly decrease the amount of pain medication needed and help you advance in physical therapy quicker.
Less Risk of Infection
Let’s face it. Hospitals are where sick people are. There are many precautions we take as healthcare professionals to limit the spread of disease, however, some germs can be unavoidable. A brand new joint can be especially susceptible to infection. We can decrease this risk by removing you from an environment where dangerous germs are far more prevalent. This is especially true in skilled nursing facilities.
There’s no place like home! You can recover from the comfort of your own bed in your own pajamas. It is not necessary to sleep in a hard uncomfortable hospital bed in a freezing cold room. You will be able to sleep peacefully instead of being awoken several times throughout the night by the nursing and ancillary staff. Also, there will be no need to wait for the nurses to bring you your medications or help you to the restroom. Nurses are very busy caring for multiple patients at the same time and sometimes it can take quite a while to assist you with your needs. At home you are able to take your medication and go to the restroom right when you need to.
An outpatient total joint replacement may even incur a lower cost to you as the patient. This may depend on insurance plan and location of the surgery.
Recommendations for a Successful Outpatient Surgery
Dedicate a Support Person
We recommend having a support person stay with you for at least the first week to help you. It is also important to arrange transportation so you can safely get to your physical therapy appointments which are an extremely important part of your recovery.
Ensure the Home is Safe
Clear all tripping hazards out of the way (i.e loose rugs, furniture, etc.). You may want consider setting up a space on the first floor if you have stairs in the house.
Participating in “Prehab”
Whether it be going to formal physical therapy or doing a focused home exercise program. The stronger you are going into this surgery the better. We recommend focusing on strengthening the quadriceps, gluts, and the hip abductors. These will help support your weight and aid with balance. All very important in speeding up recovery.
Preparation, Preparation, Preparation
Preparation in this case is key! The more you can prepare ahead of time the better. Make sure to fill all post- operative medications prior to surgery. Set up your physical therapy appointments as soon as possible so that you are able to get in a few days following the procedure. Also, purchase any medical equipment needed (i.e shower chair, toilet seat riser, etc.). Prepare meals ahead of time and store them in the freezer prior to surgery if possible.
Are You a Candidate for an Outpatient Total Joint Replacement?
Now, not every patient is a candidate for an outpatient total joint replacement. Patients with multiple medical issues that need close monitoring will likely need to stay in the hospital one or two nights for observation. Patients who are good candidates for this type of procedure are generally healthy, independent, active and with few medical conditions.
In addition to these considerations, another important factor is that you are deemed safe to go home by the medical staff and by the physical therapists. A physical therapist will see you in the post op recovery room and get you up walking on the walker shortly after your procedure. They will typically see you a couple more times. If your surgical procedure is later in the afternoon, there is a possibility of needing a one night stay to work more with physical therapy.
Interested in Learning More About an Outpatient Total Joint Replacement Surgery?
Please call our office or visit our website to schedule an appointment with one of our highly skilled San Diego outpatient joint replacement specialists today. Outpatient total joint replacement procedures can be performed both at a qualified surgery center and at the hospital. Our surgeons operate at Sharp Grossmont Hospital, Sharp Coronado Hospital, and University Ambulatory Surgery Center.