Outpatient Joint Replacement

Written by: Joseph R. Locker

“Same-day” or ambulatory joint replacement surgery is on the rise in the United States. Predictions are by 2027 over 50% of joint replacements will be done as an outpatient. Why the shift? What are the risks and benefits? Are you a potential candidate? Read on for more information.

What is Outpatient Joint Replacement?

 

Outpatient surgery assumes the patient spends less than 23 hours at a facility. Currently, Florida laws do not allow for overnight stays at Ambulatory Surgery Centers (ASCs), so for now, it means going home the same day as surgery. It could mean a hip, knee, partial knee, or shoulder replacement.

 

 Why is Outpatient gaining popularity?

 

With the advances in surgical techniques, anesthesia, and pain management most total joint patients spend less than 2 days in the hospital. For a certain subset, there is an ability to go home the same day. Outpatient is not for everyone and is decided by the patient and surgeon on a case by case basis.

 

What are the required factors for outpatient?

 

  1. Engaged healthy patients: patients with significant medical problems or those with a less healthy body weight are ideally done at the hospital to allow overnight observation. The younger, healthier patients are better candidates.
  2. An at-home support system: there must be help at home for the therapy and discharge from the ASC. If you live alone it may be difficult to go straight home from surgery.
  3. Pre-op and post-op preparation: training on crutches or a walker before surgery, preparing the house, and exercises after are extremely important to allow rapid recovery.
  4. Pain management: the evolution of pain control relies on the avoidance of heavy narcotics so fewer side effects of nausea, vomiting, and other things.
  5. Minimally invasive surgical techniques: surgery must be efficient with limited tissue damage and less pain.

 

Is it safe?

 

Yes, studies have shown that outpatient joint replacements in the right patients are not only safe but generally leads to better patient satisfaction than surgeries at the hospital.

Is the cost the same?

 

Generally, the overall cost is much less than in hospital stays, which can lead to thousands of dollars of savings for a patient.

 

Do most insurances plans cover this?

 

Insurances, including Medicare, are moving more and more towards reimbursing for outpatient joints. It depends on the private insurer currently, with Medicare only allowing outpatient total knees, and those have to be done at the hospital, although Medicare currently allows outpatient partial knee replacement.

How do I know if I am a candidate?

 

Talk to your TOI surgeon. They can discuss the different options with you to determine if outpatient joint replacement surgery is right for you.