Why Choose Same-Day Outpatient Total Joint Replacement

The first thought that frequently comes to mind after hearing same-day outpatient total joint replacement is: “I can’t go home after a major surgery like that!”  Times have changed since having a hip or knee replacement in the 1980s.  In the past, patients would be in the hospital for a week or more, and they would be encouraged to limit their mobility for several weeks afterward.

Fast forward to 2020. Now the average stay in the hospital is 1-2 nights.  Today, patients are walking within hours of surgery alongside their physical therapist who is equipped with a walker and words of encouragement. Current studies support this early mobilization after surgery, which helps prevent muscle loss, decreases the chance of pneumonia and blood clots, builds confidence and dispels anxiety after a joint replacement.

Why choose same-day outpatient joint replacement surgery

The big advantage of same-day outpatient joint replacement surgery is the ability to limit patient contact with those who are sick in the hospital setting. With the COVID-19 pandemic, this is even more critical. Studies have also reported there is no additional risk of complications between the patient who recovers at home or in the hospital after a joint replacement.

This type of surgery is made possible through improved surgical technique, new robotic technologies, multimodal pain control strategies and thorough patient instruction. Insurance companies also recognize outpatient joint replacement surgery as an option for surgeons and patients.

Ideal candidates

Not everyone is a candidate for a same-day total joint replacement.  A patient’s medical issues are the major determinant of who can have the surgery in this type of setting.  For instance, a patient with chronic heart or kidney issues would likely need to be monitored in a hospital setting after joint replacement surgery. Open communication between the patient and surgeon is crucial.  A thorough screening process is necessary to determine the patient’s motivation, home living situation and distance from the hospital in case an issue would arise after surgery. Our patients have access to a member of our joint replacement team 24-hours a day in case any issues or questions arise.

Candidates for same-day outpatient joint replacement surgery:

• Have limited medical problems
• Are highly motivated
• Have good family support to help them at home
• Live within 2 hours of the hospital
• Have open communication with surgeon

The Marshall Orthopaedics experience

When I arrived at Marshall Orthopaedics, one of my goals was to establish an outpatient same-day total joint replacement option for select patients. I had performed my first one at Wake Forest Baptist Health in North Carolina four years prior. Cabell Huntington Hospital (CHH) had completed several outpatient joint replacements in the past, but they did not do them on a regular basis. The COVID pandemic allowed us to embrace the opportunity to make this a safe and feasible option for our patients.

We recently established a same-day total joint replacement program at Three Gables Surgery Center in Proctorville, Ohio. The first procedures performed were two same-day outpatient knee replacements.  Before going home, both patients (pictured) had to spend about 6 hours at the facility recovering and receive the okay from the therapist who ensured each patient had met their functional mobility.

Our experience at Three Gables served as the blueprint at CHH.  In December 2020, our team performed a minimally-invasive direct-anterior same-day total hip replacement at CHH.  This is a true testament to the communication, dedication and teamwork required by the therapists, nursing teams and surgical staff to help the patient safely be discharged to home within 4 hours of reaching the recovery room with his new hip replacement. (View video of patient on his way home.)

For more information about same-day outpatient joint replacement, please call Marshall Orthopaedics at 304-691-1262 to schedule an office visit or telemedicine appointment. Computer-assisted technologies are available at both Three Gables and CHH for those patients seeking same-day outpatient joint replacement options.

Right to Left: Joseph Risch (patient); Dr. Matthew Bullock; Pamela Gorby (patient). Both patients had a same-day outpatient right total knee replacement using computer-assisted surgery at Three Gables Surgery Center part of Mountain Health Network.