Outpatient Joint Replacement Specialists

Why stay in the hospital when you can now recovery for surgery in the comforts of your own home.

Modern advances in anesthesia, pain management and surgical techniques make this a safe and satisfying option for a majority of patients who undergo knee, hip and shoulder replacement. The Knee, Hip and Shoulder Center leads New England in same-day-surgery joint replacement having performed closed to a thousand cases in the past few years. Put our experience to work for you.

The Knee, Hip and Shoulder is redefining how patients undergo joint replacement surgery, offering same-day discharge to home. We have more experience than any practice in Northern New England in outpatient joint replacement and we have developed the AVATAR program to allow suitable patients this option. Outpatient surgery allows patients to recover in the comfort on their own home.

Advantages of outpatient surgery


7 Key Factors to Success

Engaged, Healthy Patients:

Patients must be relatively healthy and not have any medical problems that require active management or place patients at increased risk for complications. Patient engagement refers to the process of taking an active role in the preparation and education process. The more educated patients are prior to surgery, the more likely they are to succeed in their recovery.

A Home Support System:

Patient returning home the day of surgery must be accompanied by a family member or friend. Appointing a dedicated “coach” prior to surgery is key as this person can also engage in the education process and assist in postoperative care and recovery.

Pre-op Health Optimization and Risk Mitigation:

Risk factors for complication after joint replacement are well defined and any risks should be addressed preoperatively through a health optimization process. Addressing modifiable risk factors reduces complications and readmissions.


Strengthening the muscles that support the joint prior to surgery can speed and improve recovery. This is called “prehabilitation.” This process can include a home evaluation so that patients can prepare their home to optimize the recovery process.

Improved Surgical Techniques:

Advances in implant designs and surgical technique can reduce tissue trauma, decrease blood loss and reduce the risk of infection.

Better Pain Management:

Pre-emptive analgesia refers to starting medications prior to surgery. This has proven to reduce postoperative pain allowing patients immediate mobilization. Multimodal pain management refers to using multiple different types of medication to reduce pain. These often include Tylenol, anti-inflammatories, Tramadol. This combination works synergistically to reduce the amount of narcotics needed.

Anesthesia Techniques:

Short active spinal anesthetics reduce side effects associated with general anesthesia and allow patients to wake up quickly with less grogginess and nausea. Regional nerve blocks also numb the surgical area markedly reducing postoperative pain and allowing immediate mobility. Finally, long acting local anesthetics injected into the tissue around the joint provides persistent pain relief for several days after the block wears off.