Although we can’t see the future, we can look at the direction in which joint replacement surgery is heading and make predictions about what the future of orthopedics may look like. One important signal is the increasing numbers of hip and knee replacement surgeries being performed in an outpatient (ambulatory) setting. Outpatient joint replacements are often called “same-day” replacements because the patient hospital stay is less than a full day.
For a quick summary of the 13 Things You Should Know About Same-Day Hip and Knee Replacement Surgery, read on! At the end of this post, we hope that you’ll have a better idea if outpatient surgery is right for you.
13 Things Patients Should Know About Same-Day Hip & Knee Replacement Surgery
1. It’s the future of joint replacement surgery.
Between 2012 to 2015 there was a “47% increase in elective outpatient hip and knee replacement procedures”. Over the next 10 years the number of patients having same day hip replacement surgery and same day knee replacement surgery is expected jump by 457% and 633% respectively.
This means that by 2027 more than 50% of joint replacements will be performed in an outpatient setting.
2. The rumors are true: the episode lasts under 24 hours.
Outpatient joint surgery is performed in a special hospital unit or separate outpatient (ambulatory) care center. The admission, procedure, and discharge all happens in less than 24 hours. Some patients playfully call it a “drive-by” surgery.
3. You won’t be discharged until you’re ready.
Your care team’s number one priority is your health and safety after surgery. If you aren’t able to walk after surgery, are having even minor complications or have abnormal labs after the procedure, you will be kept longer or transferred to a traditional hospital. Although “same day” replacements mostly mean “same day”, you will be accommodated if you aren’t ready for discharge within 24 hours.
4. It’s your choice.
As it currently stands you can decide whether or not you want an outpatient surgery. Although same-day joint replacements may be the only option in the future, for now, it’s up to you and your surgeon. Even if your surgeon or care team recommend you have a same-day hip or knee replacement, it’s only a “go” if you’re comfortable and think you can benefit from less time in hospital.
5. It’s only recommended to the healthiest patients.
Since there is less in-hospital support, your care team will only suggest same-day surgery if they think you are healthy, engaged, and have a support system in place for your recovery. Patients with comorbidities (secondary diseases or conditions), who are older, with a higher BMI, or have less support at-home are unlikely to be steered towards an outpatient procedure. If you’re being recommended same-day surgery, it’s a safe bet that you’re healthier, fitter, or younger than the average patient.
“I tell patients this is something they ‘get’ to do because they’re healthy enough. It’s not an experiment; they are in good shape and fortunate enough to have the ASC [Ambulatory Surgery Center] experience”- Dr. Sciortino, MD, Orthopaedic Surgeon.
6. You will have less support from your care team.
Same-day surgery can feel rushed and overwhelming for some patients. Without a doubt, outpatient surgery does not offer as much caretaking by your medical team during the early days of recovery. You will not get around-the-clock in-person care after surgery, but you won’t be on a lonely island either. The more you prep for at-home rehabilitation, the more confident and comfortable you will feel guiding your own recovery.
7. More preoperative preparation (PreHab) is required.
Since there is less “hand-holding” from your medical team, patients should be as mentally, physically and environmentally prepared for surgery as possible. Patients who prepare for surgery are able to mobilize faster after the procedure and are leaps and bounds ahead of those who do not PreHab. Being prepared for outpatient surgery means doing as much as you can before the procedure to set yourself up for a faster and easier recovery.
8. Outpatient surgery patients have a lower risk of infection.
A shorter hospital stay lowers the risk of infections from the hospital itself. MRSP and other infections from surgery and the hospital will hijack your recovery and cause serious complications. Spending less time in the hospital means less exposure to the bacteria and infection circulating in that care facility.
9. Same-day = greater patient satisfaction.
According to a few published studies, outpatient joint replacement recipients tend to be more satisfied with the care they’ve received and their overall replacement. Ortho Illinois, reports that “patients and their families consistently rate their experience as more pleasant at an outpatient surgery center.”
A study comparing overall satisfaction in outpatient versus inpatient partial knee replacement (PKR) patients, found “increased patient satisfaction and improved outcomes” in the group that had “accelerated recovery protocol and decreased length of hospital stay”.
10. Improved surgical techniques have made outpatient surgery possible.
The advancements made to the way surgery is performed (like minimally invasive method or robotic surgery) make the surgery less invasive on the body. This means that there is less blood and muscle loss and recovery is measurably easier on the body. Other factors like better pain management techniques and improved anesthesia that have evolved allowing outpatient surgery to be possible on some elective procedures (like joint replacement surgery). Without these medical advancements, recovery at-home would be too risky.
11. Recovery happens at home.
Unlike a traditional hip or knee replacement where patients spend an average of 2 days in the hospital and then are discharged to a secondary care facility, a rehab, or home, outpatient patients recovery at-home right away. Although outpatient surgery is more hands-off than inpatient, your care team will check-in via telephone and a physical therapist will visit you several times a week. You should also be given more information (and hopefully post-op education) and tools to monitor and propel your own recovery.
12. You need at-home caretaking support.
Whether you live with your recovery caretaker or will have family or friends checking in regularly, do not underestimate how much you will rely on your support system after surgery. As you recover, there will be a host of things that you will not be able to do right away without assistance like driving to appointments, walking the dog, grocery shopping etc. Making sure that you have a network in place to support you physically and emotionally is a key part of successful recovery from outpatient joint replacement surgery.
13. It’s less expensive, but this may not concern you.
Depending on your insurance coverage, price may or may not factor into your decision to go outpatient or not. If the overall cost of your joint replacement surgery is front of mind, a same-day replacement is significantly less costly. In fact, as reported in the Orthopedic Journal of Sports Medicine, “significant cost savings of roughly 50% can be achieved with an outpatient UKA (partial knee replacement) protocol done at an outpatient surgical facility.” Numerous studies have shown substantial savings for providers when patients spend less time in the hospital and are discharged home instead of to a secondary facility. This is a key reason why outpatient surgery is being pushed as a cost-savings alternative for patients who can benefit from this type of procedure.
Whether you like the idea of recovering at home or spending more time in hospital, preparing for joint replacement surgery is the best thing you can do to better your outcome. Sign-up and get matched with a surgeon who offers PeerWell’s leading joint replacement PreHab program for free. Recover your way—faster and better—with PeeWell’s PreHab and ReHab app.