Understanding Outpatient Joint Replacement Recovery

December 29th, 2020

Total hip and knee replacement surgery can be a quick turnaround for many patients today. It is indeed possible for some patients to safely undergo outpatient and same day discharge for these procedures. This is a clear advantage for those having surgery during the Covid-19 pandemic. The pandemic has led to an increase in both patients and surgeons’ enthusiasm about shorter hospital exposure and quicker recovery. Patients who have outpatient surgery are generally healthy and do not desire an inpatient stay. 

These patients can go home the same day as their surgical procedure. However, not all patients are candidates for this type of outpatient surgery.  A patient must meet specific criteria. They must be healthy, fit, and motivated. They must have a support system in place for their recovery, including the help of family or friends. Patients interested in same day surgery should discuss the pros and cons with their doctor to find out if they are in fact a candidate. 

Advantages of Outpatient Surgery

The advantages are clear. Avoidance of a hospital stay limits potential exposure to COVID-19 infection. Patients also may be happier at home. They can sleep in their own bed, interact with family members and eat meals of their choice. A good night’s sleep can aid in recovery and potentially lead to a better state of mind. Patients can also be more independent at home.  They don’t need to rely on nurses and hospital staff.  They can recover on their own schedule.  Get up when they want, walk when they want, and eat when they want.  

Concerns of Outpatient Surgery

Some patients are apprehensive to have outpatient surgery as they are worried or anxious about having less medical supervision. Recent information shows that healthy patients are not at increased risk and that there is not an increased risk for complications, readmission or emergency room visits [1-3]. In addition, some patients are concerned about having pain or nausea after surgery. Patients who go home the same day will be discharged on the same medications they would get in the hospital. In fact, the patients can manage their own medications and take them when they need.They don’t need to rely on nurses or staff to administer the medication. Other patients are concerned about less exposure to physical therapy. Recent evidence shows that not having formal physical is not inferior to formalized therapy programs. [4, 5]

Recent studies show that in the appropriate patient there is not an increased medical risk of having a procedure as an outpatient. The advantages of outpatient joint replacement surgery are many, for the right patient. It’s a decision that should be made after consideration and discussion with your physician. 

If you’re considering surgery and in need of a consultation, click here to make an appointment at Rothman Orthopaedics.
References:


1.    Goyal, N., et al., Otto Aufranc Award: A Multicenter, Randomized Study of Outpatient versus Inpatient Total Hip Arthroplasty. Clin Orthop Relat Res, 2017. 475(2): p. 364-372.
2.    Klein, G.R., et al., Same Day Total Hip Arthroplasty Performed at an Ambulatory Surgical Center: 90-Day Complication Rate on 549 Patients. J Arthroplasty, 2017. 32(4): p. 1103-1106.
3.    Springer, B.D., et al., Impact of Inpatient Versus Outpatient Total Joint Arthroplasty on 30-Day Hospital Readmission Rates and Unplanned Episodes of Care. Orthop Clin North Am, 2017. 48(1): p. 15-23.
4.    Austin, M.S., et al., Formal Physical Therapy After Total Hip Arthroplasty Is Not Required: A Randomized Controlled Trial. J Bone Joint Surg Am, 2017. 99(8): p. 648-655.
5.    Fleischman, A.N., et al., 2018 John N. Insall Award: Recovery of Knee Flexion With Unsupervised Home Exercise Is Not Inferior to Outpatient Physical Therapy After TKA: A Randomized Trial. Clin Orthop Relat Res, 2019. 477(1): p. 60-69.
 

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