Grossmont Orthopaedic Medical Group offers same-day surgery for qualified patients. Same-day surgery has numerous benefits. You may know someone who has undergone hip, knee, or shoulder surgery and went home the same day. In the past, surgeries of this significance required at minimum of an overnight hospital stay. Fortunately, with advances in surgical techniques, anesthesia medications, pain management and rehabilitation, some patients can now undergo orthopedic surgery without spending a single night in the hospital.

As of now, only a small percentage of people are candidates for outpatient (also referred to as “same-day”) hip, knee, and shoulder surgery. This is expected to grow as surgeons become more experienced in outpatient surgery and techniques for pain management and outpatient care improve.

The Centers for Medicare and Medicaid services (CMS), the government agency that controls payments for the care of Americans who are enrolled in the program, is expanding the list of authorized orthopedic surgeries that can be performed at outpatient surgery centers.

Advantages of outpatient orthopaedic surgery

Familiar environment

1. You may be more comfortable recovering at home.
2. You will be in a familiar environment with all the conveniences of being at home and having family to help.
3. You’ll be able to sleep in your own bed and not be woken up throughout the night by hospital staff for regular checks or from other noises that are part of the hospital environment.
4. You will be able to eat your own food.

You’re in control of your medication

• You will be in charge of your pain medication regimen without waiting for medications to be brought to you.

You’re at less risk of infection

• There is less risk of infection by getting out of the hospital environment.

Cost savings

• There is potential cost savings to both you and your hospital. If you have a high insurance deductible or coinsurance payment, you may save a substantial amount of money by skipping the cost of overnight hospital care.

Who can have outpatient orthopaedic surgery?

If you are healthy and active with no major or ongoing medical problems, then you might be a good candidate for outpatient surgery. Typically, younger patients who are walking without assistive devices (like canes or walkers) before surgery may be good candidates.

Your motivation to get better is a key part of doing well with outpatient orthopaedic surgery, and it is very important to keep a positive attitude. The board-certified orthopaedic surgeons at Grossmont Orthopaedic Medical Group can help you decide if you could be a candidate for outpatient hip or knee replacement surgery.

Who shouldn’t have outpatient orthopaedic surgery?

If you have a serious medical issue, then it may be best to stay in the hospital for one or two days after surgery to make sure that your medical problems are stable before you go home. Patients with medical conditions such as heart disease, congestive heart failure, poorly controlled diabetes, chronic lung disease, chronic kidney disease, sleep apnea, or who take daily steroid medications will most likely not be candidates for outpatient orthopaedic surgery. The same holds true for patients with balance problems or chronic neurologic disease who have had difficulty walking before surgery. Patients who live alone and have no one to care for them at home are also not candidates.

Getting ready for outpatient orthopaedic surgery

If you and your orthopedic surgeon at Grossmont Orthopaedic Medical Group have determined that it is safe for you to have outpatient surgery, it is essential to make plans before the day of surgery. Include your friends and family in the plans – especially those who will be staying with you and caring for you after you return home. A family member or friend can serve as a coach and is an important part of the process as you make plans.

• Prepare your home: remove loose rugs, board pets, prepare and freeze meals.
• Plan your care: fill prescriptions, make appointments for nursing care and physical therapy.

Surgery Day

These videos show you what to expect on the day of surgery for hip replacement and knee replacement:

• Hip Replacement – mini-posterior and anterior approach
• Knee Replacement – total and partial

After surgery and going home

When your orthopaedic surgery is complete, you will spend time in a post anesthesia care unit (PACU). This is an area in the facility that allows you to recover from your surgery. You will work with a therapist or a nurse to get out of bed to a chair and then start walking. If you have stairs at home, this may include practicing walking up and down stairs. Before you are ready to go home, you should:

• Be safe walking with crutches or a walker
• Feel good enough to eat solid food and drink liquids with no nausea or vomiting
• Not have any dizziness or drowsiness
• Urinate without difficulty before leaving
• Have stable vitals signs such as blood pressure and heart rate
• Have pain well controlled with oral pain medicine

Before leaving the facility, you will be given prescriptions for pain medicine and blood thinners. You will also typically be given instructions for activity and wound care and information on whom to contact if you have any problems at home.