JOINT HEALTH
Joint replacement, which is often the surgical treatment for end-stage hip and knee (and shoulder) osteoarthritis, is rapidly becoming one of the most commonly performed procedures in orthopedics. Osteoarthritis develops when cartilage (the “cushion” in the joint) wears away, which can eventually result in bones rubbing against each another. This can lead to joint pain and stiffness. If nonsurgical treatments, such as anti-inflammatory medications, physical therapy, and joint injections, do not provide adequate pain relief, joint replacement may be a viable option.
Advancements in perioperative pain management protocols, regional anesthesia, and less invasive surgical techniques have allowed earlier mobilization and accelerated recovery after joint replacement. This has led to the concept of performing outpatient joint replacement procedures. Outpatient joint replacement essentially involves having surgery in the morning and going home in the afternoon so that you sleep in the comfort of your own bed that night. Prior to going home, you will participate in physical therapy and demonstrate that you can walk and navigate stairs safely. Potential advantages of outpatient joint replacement include lower cost, improved health and comfort, faster recovery, and higher patient satisfaction.
You may be asking yourself, “but is it safe?” Recent literature has demonstrated that outpatient joint replacement, when performed in appropriately selected patients, can be safe and effective. Retrospective analysis has demonstrated that outpatient joint replacement did not increase the risk for complications or readmissions. It is important to recognize, however, that not all patients are candidates for outpatient joint replacement. Patients with significant medical comorbidities, such as poorly-controlled diabetes, bleeding disorders, and higher ASA physical status (American Society of Anesthesiology), or those who do not have an at-home support system should consider surgery in the hospital setting as a precaution.
If you and your surgeon agree that you are a good candidate for outpatient joint replacement surgery, it is essential that you are ready for the day of surgery. Prepare your home before surgery by removing clutter or any potential obstacles in your path. Consider having hand rails installed, and plan your meals ahead of time. Obtain assistive equipment, such as a walker and grabber. In addition, prepare your body by performing pre-habilitation exercises to strengthen the surrounding musculature and by optimizing your diet to accelerate wound healing. Adequately preparing for surgery is essential to succeeding in the recovery process!
The benefits of outpatient joint replacement are reflected in its increasing popularity throughout the country. A recent study published from the Hospital for Special Surgery reported that outpatient hip and knee replacement surgery increased by an average of 16% and 11% each year between 2010 and 2017. In the wake of the COVID-19 pandemic, these rates are likely to rise further.
