Why: Hospitals are a place for sick people. They are noisy and uncomfortable and they disempower patients to care for themselves. Patients undergoing knee and hip replacement are rarely “sick”. Rather they are well patients with a degenerated joint, looking to get better quickly and safely. Historically, patients would spend 2-3 days in the hospital after joint replacement surgery predominantly for pain management and early physical therapy. However, improvements in surgical technique, anesthetic techniques and patient preparedness now allow patients to return home just hours after knee and hip replacement and recover in the comfort of their own home. This allows patients to manage their recovery in real time and now according to a hospital prescribed schedule or at the mercy of a busy nurses workload. Studies have now proven that same day joint replacement is quite safe for a majority of patient and currently 60-70% of our patients return home the same day.
How: Same-day joint replacement requires a coordinated and well navigated approach to the perioperative process. We have developed a program called AVATAR Alignment of Vital Assets to Accelerate Recovery).
- This program starts with comprehensive patient education about the possibility and process for this. An educated patient is much more likely to succeed and we invest the time in making sure our patients understand the tenets and advantages of same-day surgery.
- Preparation for surgery is also vital. We focus on conditioning patients both mentally and physically for surgery including preoperative health optimization, nutritional optimization and fitness. A prepared body and mind recovers faster and handles stress better.
- We employ the best surgical techniques that minimize tissue trauma and we use implants with a proven track record that are based on results not gimmicks.
- Pain Management: we use modern anesthetic techniques including regional nerve blocks and long-acting local anesthetics during the surgery to reduce postoperative pain. We tailor this program to the patients individual needs. We also use a comprehensive multi-modal postoperative regimen of medications that are designed to keep pain at a manageable level while minimizing potential side effects.
- Immediate mobilization is important and we focus on getting patients on their feet and going right away. This prevents stiffness and promotes muscle activation and recovery. We use a continuous passive motion machine for knee replacements during the first 2 weeks which prevents scar tissue formation and reduces swelling.
- Finally, we help patients navigate this process through close communication between all care providers involved in the perioperative and postoperative period.
There is no substitute for experience in successful same-day joint replacement. Together our center has performed over 1000 of these cases over the past few years. This has allowed us to perfect this process and become regional leaders in offering this service. No other practice in northern New England can claim the expertise and experience we have with the techniques involved in an outpatient joint replacement program. Call us today if you would like to learn more about this.