Outpatient joint replacement surgery does not require an overnight stay at the hospital. This procedure is known as a rapid recovery surgery, which means the patient is back to usual activities soon after the surgery.
What is knee replacement surgery?
Outpatient knee replacement surgery is a surgical procedure in which the damaged, worn joint surfaces are removed and replaced with artificial components (prosthesis). This rapid recovery procedure is done on an outpatient basis, allowing the patient to go home soon after the surgery.
Who is a candidate for rapid recovery knee replacement surgery?
Your doctor may consider this knee replacement procedure if you:
- Have severe pain that limits your daily activities
- Suffer pain that is not relieved with physical therapy, medications, and knee injections
- Have an active lifestyle that requires you to be on your feet
- Are in relatively good health otherwise
- Have a high level of motivation during the rehabilitation process
- Good family support
What are the benefits of rapid recover knee replacement surgery?
The benefits of outpatient knee joint replacement surgery include:
- No overnight hospital stay
- Earlier mobilization
- Rapid recovery
- Fewer complications
- Improved pain scores
- Increased patient satisfaction
How do I prepare for the rapid recover knee replacement procedure?
Before surgery, the doctor will do some preliminary tests and have you hold certain blood-thinning agents for several days. You should arrange to have someone drive you home, and leave all valuables at home. When you arrive at the surgical center, a nurse explains the procedure, and you must sign a consent form. After changing into a procedure gown, the nurse places an IV catheter in your arm.
How is the rapid recovery joint procedure performed?
The rapid recovery knee replacement procedure is performed almost the same as traditional joint replacement surgery. Smaller incisions and less tissue manipulation allows the patient to recover at home instead of in the hospital. The procedure is done under general anesthesia. The surgeon makes 1-2 small incisions, removes damaged joint components, and inserts the prosthesis. After making necessary repairs, the incisions are closed with sutures.
What can I expect after the procedure?
You will be monitored in the recovery area for around 1 hour. After being discharged, a nurse comes to the patient’s home to monitor the condition, and a physical therapy visits several days a week to instruct the patient on flexibility and range of motion exercises. We emphasize ambulating and weight-bearing as tolerated with a cane or single crutch. Pain medications are only to be used as needed, and we stress the use of short-term anti-inflammatory drugs.
What do the research studies show?
A group of researchers studied the safety and feasibility of outpatient knee replacement surgery in a group of individuals with unicompartmental knee osteoarthritis. All 105 patients (100%) were discharged on the same day of surgery, and none of them required readmission to the hospital. The researchers concluded that rapid recovery knee replacement was a feasible, safe procedure for the majority of patients.
In a review of 4,500 total hip and knee replacements, researchers found that following a strict multimodal enhanced recovery protocol reduced the 30-day death rate, length of hospital stay, requirements for blood transfusion, and chance of heart attack, stroke, and pulmonary embolism. The protocol involved behavioral, procedural, and pharmacological modifications, such as use of certain medications before surgery and physical therapy after surgery.
Cross MB & Berger R (2013). Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop, 38(2), 443-447.
Malviya A, Martin K, Harper, I, et al. (2011). Enhanced recovery program for hip and knee replacement reduces death rate: A study of 4,500 consecutive primary hip and knee replacements. Acta Orthop, 82(5), 577-581.