Outpatient Total Joint Replacement in the Surgical Center Setting

Outpatient Hip and Knee Replacement: A New Era in Orthopaedic Care

Just a decade ago, the idea of going home the same day after a hip or knee replacement would have seemed far-fetched, even risky. Today, outpatient total joint replacement is not only possible but increasingly common, safe, and effective. Thanks to advances in surgical technique, anesthesia, pain control, and rehabilitation protocols, we’ve entered a new era in orthopedic care, one that prioritizes patient comfort, faster recovery, and efficient care with fewer medical interventions in settings like ambulatory surgical centers (ASCs).

As an orthopedic surgeon specializing in hip and knee joint replacement, I’ve seen firsthand how these changes have transformed the patient experience. In this article, I’ll walk you through how and why outpatient joint replacement is possible, whether you might be a candidate, and what the benefits and outcomes typically look like.

The Evolution of Joint Replacement Surgery

Hip and knee replacements have long been among the most successful procedures in medicine. Traditionally performed in hospitals with several days of inpatient recovery, these surgeries relieve pain, restore function, and dramatically improve quality of life for people with advanced arthritis.

Over time, however, innovations in every stage of the process have changed what’s possible:

• Minimally Invasive Techniques: Modern surgical approaches and techniques cause less trauma to surrounding muscles and tissues, reducing pain and speeding up recovery.
• Enhanced Pain Management: Multimodal pain control strategies — including regional nerve blocks and non-opioid medications — mean patients experience less pain and are able to move sooner.
• Improved Implants and Technology: Today’s implants are more durable and anatomically precise.  Implants can be used in combination with technology to create a joint replacement that will last decades while supporting a faster return to activity in the early phases of recovery.  
• Streamlined Protocols: Preoperative education, optimized anesthesia, and coordinated post-operative physical therapy have created efficient “fast-track” pathways to recovery.  Traditional medical interventions such as foleys, drains, lab tests, and dressing changes are eliminated. 

These advancements have made same day discharge a safe and realistic option for many patients.

What Is an Outpatient Joint Replacement?

An outpatient joint replacement is a hip or knee replacement surgery performed in a setting that allows the patient to return home the same day—typically at an ambulatory surgical center (ASC) or sometimes in a hospital with an outpatient program.

Surgical centers are highly specialized facilities that focus on same-day procedures. They are designed to be efficient, patient-friendly, and cost-effective, while maintaining the highest standards of safety and care.

Who Is a Candidate?

Outpatient joint replacement isn’t for everyone—but many people qualify, especially those who are relatively healthy and motivated to recover at home. During your consultation, we look at several factors to determine if outpatient surgery is a good fit:

• Overall Health: Patients without significant heart, lung, or kidney issues tend to do best.
• Support at Home: You’ll need a caregiver for at least the first 24–48 hours post-surgery to assist with basic needs.
• Body Weight and Mobility: Individuals who are not severely obese and who can walk with minimal assistance before surgery typically recover more easily.
• Motivation and Understanding: Patients who are actively involved in their care and understand what to expect are more likely to succeed.

Age alone is not a disqualifier. Many patients in their 60s, 70s, 80s, and even 90s have safely and successfully undergone outpatient joint replacement.

In fact, a patient of mine, Kathryn Patterson, was in her late 70s when she went through Outpatient Joint Replacement and was kind enough to speak about her experience. “That was the most amazing thing, being able to have the surgery same day,” says Kathryn, “I am going to be 81, it’s been about 3 years since the surgery, and (at the time) was really surprised that at my age they would do same day surgery.”

Kathryn shared that “I had to be there at 7 in the morning, and of course, it’s a lot of prep and paperwork, but I was back home by 2 in the afternoon.” With no physical therapy needed and no pain since, Kathryn has gone on to recommend outpatient joint replacement to her friends dealing with similar issues.

“I was thrilled that I had no more pain after that, and after a few days, I didn’t even know where my walker was!”

The Benefits of Outpatient Surgery

The benefits of outpatient total joint replacement are significant and well-documented:

1. Faster Recovery: Ambulatory surgical centers prioritize early mobilization after surgery with fewer medical interventions to hold you back.  Upon discharge, being in your own home, sleeping in your own bed, and moving around familiar spaces can all promote faster healing.
2. Lower Risk of Infection: Surgical centers often have lower infection rates than hospitals, partly due to a lower volume of sick patients.  Some of these centers are strictly designed for orthopedic surgery and ‘clean’ surgery.
3. Improved Comfort: The outpatient surgery setting is streamlined to focus on a smaller number of patients and more personalized care.  Upon discharge, many people feel more relaxed and in control when recovering at home.
4. Cost Savings: Outpatient procedures tend to be more cost-effective for both patients and insurers due to shorter stays and reduced hospital overhead.
5. Patient Satisfaction: Studies show high satisfaction rates among patients who undergo outpatient joint replacement, especially when expectations are clearly defined and met.

What to Expect Before, During, and After Outpatient Joint Replacement

• Before Surgery: We’ll guide you through a preoperative program that may include physical therapy, medication review, home safety planning, and education about what to expect. Some centers also offer “joint class” seminars for patients and caregivers.
• The Day of Surgery: You’ll arrive at the surgical center in the morning, meet with your surgeon and anesthesiologist, have your procedure (which typically takes 1–2 hours), and spend a few hours in recovery. Soon after surgery, you will meet simple metrics of walking with assistance, eating, and urinating in order to be discharged home.
• Recovery at Home: Most patients are walking with a cane or walker initially. Physical therapy may be prescribed.  Many patients return to driving in 2-3 weeks and return to sedentary jobs by 6 weeks. Full recovery can take several months. Outpatient surgery patients often meet milestones more quickly due to early mobility and less disruption to their routines.

Addressing Concerns About Safety

Naturally, one of the first questions I hear is: “Is it really safe to go home the same day?”

The answer is yes—for the right patient, in the right setting, with the right support. Studies have shown that outpatient joint replacement has comparable—if not better—outcomes than inpatient surgery for selected patients. The risk of complications, readmissions, and infections remains low, and often lower than the hospital setting, especially when care is well coordinated.

A key component of our preoperative assessment is evaluation of each individual in order to guide them toward the safest and most effective path for their needs.

A New Standard of Care

Outpatient joint replacement reflects the direction modern healthcare is moving — towards greater personalization, efficiency, and value. It’s not about doing more with less, it’s about doing better with smarter systems and engaged patients.  This creates a better patient experience and often optimized outcomes.

If you’re living with hip or knee arthritis and considering surgery, talk with your orthopedic surgeon about whether outpatient care at a surgical center might be right for you. You might be surprised by how far we’ve come, and how quickly you can be back on your feet. To schedule a consultation, visit our Appointments page today!