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Outpatient Joint Replacement

In this article, Orthopedic Surgeon Dr. Klaassen discusses his experience with outpatient joint replacement surgery. 

Outpatient joint replacement has reached a new high because of technology and the current COVID-19 pandemic. I believe outpatient joint replacement will become the new “normal”.

One of the biggest fears about having joint replacement that patients have is pain and not being able to move. As surgeons, we too are concerned with caring for our patient’s pain, infection and bleeding. Thankfully, evolving technology has given us new methods of doing joint replacements and managing pain and bleeding. We have many ways to manage pain that often includes a combination of treatments, as well as long-acting anesthetic methods to give pain relief for 48 to 72 hours after a procedure. This helps gets you through the worst part. It doesn’t take all the pain away but it does make it more tolerable.

One of my goals is to not use opioids. This can be managed through a combination of non-opioid oral medications in a very specific regimen. This helps minimize nausea, vomiting, and constipation after surgery. However, patients experience different levels of pain after surgery and some patients may require opioids, post-operatively. Talk to your surgeon about his/her post-surgery pain management regimen and what might be right for you.

Outpatient surgery allows you to be with your family in a familiar environment, for many patients; all patients are not candidates for outpatient (same-day) surgery and only and you and your surgeon can determine what is appropriate for you. You traditionally receive antibiotics before, during and after surgery. You receive “pre-hab” (physical therapy) before surgery.

Right after surgery, you will try using a walker to make sure you can handle it. You will be taught how to navigate steps, use the bathroom, get into a vehicle, and into bed. The idea is that you can get from the bathroom - to the kitchen - to the living room - to the dining room - on your own without assistance other than a walker. Nobody should have to lift you.

A walker, or other walking aid, is typically used for the first 3 days to prevent falls as the numbness may make your leg suddenly give way. We want to help support your knee or hip until the numbness has worn off which takes about 72 hours. After that, if your surgeon agrees and you’re comfortable doing so, you can switch from a walker to a walking-stick or cane in the opposite arm. 

Patient Guide to Outpatient Joint Replacement

Did you know that some joint replacement procedures have the option for outpatient surgery? Click here for a free guide to outpatient joint replacement surgery.

In surgery, technology and medication has improved so much that we have more methods to control pain and bleeding. We are able to do these procedures in a much less invasive manner with new instrumentation and modern Implants. This minimizes injury to your tissues, ligaments, and muscles. Some surgeons use robotics to help with accurate placement and sizing of the implants. We have the help of MRI and CT technology to allow us to identify the best possible implant fit and size. All of this technology is designed to help surgeons perform joint replacement faster and more accurately.

Many surgeons will also stay connected with you by email, messaging, or phone so that your questions can be answered and you’re reminded about your next steps. Some surgeons even have access to mobile apps, or other technology, that help them stay connected with their patients throughout their recovery, monitor our patient’s activity, watch for any problems, and can remind them of exercises.

Many patients ask, "Why do I have to stay in the hospital? I’m not 'sick'. I want to recover in the comfort of my own home." Some patients need to be more closely monitored for a day or two after joint replacement surgery. One silver lining of this pandemic as it relates to joint replacement, is that it has prompted awareness that many joint replacement candidates are well-suited to recover at home by undergoing outpatient surgery. Outpatient surgery can be done at an ambulatory surgical center (ASC) or at a hospital’s surgical center.

Some patients do require some period of hospitalization; however, they are usually people that have another preexisting condition like lung or heart disease, kidney failure, are not strong enough to start immediate recovery at home, or do not have a caregiver or any assistance at home. Your medical conditions should be well-controlled by your family doctor or internist, and only you and your surgeon can determine whether outpatient joint replacement surgery is appropriate for your specific circumstances. Not all candidates for joint replacement surgery are candidates for outpatient surgery. As with any surgery, there are risks of joint replacement surgery. You can read more about those by clicking a corresponding link below and discussing all risks with your surgeon.

The thought of overnight stays in the hospital can be scary. It can also be stressful to plan time away from loved ones for surgery. One of the goals of outpatient surgery is to return patients to the comfort of their own environment as soon as it is deemed safe to do so. If you are considering joint replacement, talk to a surgeon to see if outpatient surgery is right for you.

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