Outpatient Joint Replacement: Experience Matters

May 9, 2019

Sleeping in your own bed is more comfortable than sleeping in a hospital bed. Hospitals are uncomfortable and loud and sleep is quite difficult. When recovering from surgery, a sleepless first night can significantly reduce patient satisfaction with the experience of surgery. Historically, joint replacement surgery was associated with a 3-day hospital stay. The main driver for this was the feeling that patients “had” to be in the hospital. Modern techniques in pain management, patient education, care coordination and improvement in surgical techniques have now made same-day joint replacement entirely feasible for a substantial number of patients. And with the recognition that hospitals are places for sick people, more and more patients are beginning to see the benefits of outpatient surgery and value of recovering in the comfort of their own home. In some centers, this is now becoming the standard of care. The conception that hospital stays are mandatory after joint replacement is slowly changing as more data shows this to be safe and effective.

As a result, more and more centers are beginning to offer outpatient joint replacement for very select patients. The transition to do this has been largely process-based at may institutions which have developed rigid protocols that must be adhered to in order for patients to be discharged. Due to such stringent criteria, many centers have had difficulty generating much experience with outpatient joint replacement and while they may be advertising their institution as a center which offers this, they have little expertise in managing this process.

Our joint replacement center, using our AVATAR outpatient surgery program has performed over 1300 same-day knee, hip and shoulder replacements over the past several years. This is more combined experience than any other center regionally and many other centers total experience combined. Why is this important? Because experience matters when it comes to expertise. Knowing how to do this safely and successfully is critical to outcomes and to navigating patients through this process. Our center’s outcomes for this has proven highly successful with numbers for infection and readmissions that are far superior to national norms for inpatient joint replacement care.

What you should know as a patient: Outpatient joint replacement is a growing trend and is here to stay. This will likely become a new standard as patient acceptance of outpatient joint replacement grows and misconceptions about the need for a hospital stay are slowly redefined. Patient satisfaction with this has been very high but finding a center with substantial experience in this technique is important and you should choose your surgeon wisely.