Outpatient Total Joint Replacement

Outpatient total joint replacement (also known as same-day joint replacement or ambulatory joint replacement) has seen remarkable growth in recent years. This surgical approach has transformed how we think about joint replacement, offering patients a faster and more convenient path to recovery.

In this article, we will explore the evolution of outpatient total joint replacement and the factors that have made it a viable option for many patients.

At Orthopedic Specialists & Sports Medicine, we are committed to providing you with the highest level of care in a comfortable, professional atmosphere, as well as at a more affordable price. That’s why we offer hip, knee, and shoulder replacements at our state-of-the-art outpatient surgery center.

Our Northpointe Surgical Suites are fully equipped to provide outpatient procedures, which typically cost 40% less than inpatient surgery.*

What is Outpatient Total Joint Replacement?

Traditionally, total joint replacement surgeries required patients to be admitted to a hospital for a period of post-operative recovery. However, outpatient total joint replacement has changed all that. Patients undergoing this procedure are discharged on the same day as their surgery, allowing them to recover in the comfort of their homes. This innovative approach is particularly popular for outpatient hip, shoulder, and knee replacement patients.

The Evolution of Outpatient Joint Replacement

Outpatient joint replacement has been performed in the U.S. for more than two decades. Initially, the concept of performing a joint replacement procedure as an outpatient was met with skepticism.

The very first total hip replacements necessitated hospital stays of up to three months. However, medical advancements have revolutionized this field in the following ways:

Effective Anesthetics and Pain Control

One key factor that made outpatient joint replacement possible is the development of more effective anesthetics and pain control methods. Techniques like spinal and epidural injections for hip or knee replacement have played a pivotal role in numbing specific areas for surgery.

Similarly, brachial plexus injections have enabled complete numbness for shoulder replacement procedures. Furthermore, injections of local anesthetic medications around the surgical area provide long-lasting pain relief and reduce the reliance on opioid pain medication.

Multimodal Pain Management

The concept of “multimodal pain control” involves using a combination of pain medications, including acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), to minimize the need for narcotic pain medication. This approach ensures better and safer pain control, promoting a more natural recovery process.

Refined Surgical Techniques

Advances in surgical techniques have not only reduced procedure times but also minimized blood loss during surgery. The introduction of tranexamic acid (TXA) has further lowered blood loss, making blood transfusions exceedingly rare after total joint replacement surgery. These advancements have significantly contributed to faster recoveries.

Improved Patient Selection

Over the years, surgeons have honed their ability to identify patients suitable for outpatient surgery. Factors such as age, pre-existing medical conditions (including chronic obstructive pulmonary disease), and the availability of social support at home are carefully considered during the selection process.

Focused Physical Therapy

The integration of more focused physical therapy and occupational therapy immediately following surgery has become the gold standard for hip, knee, and shoulder replacement patients. Research consistently shows that getting patients out of bed and moving around shortly after surgery leads to quicker discharges and better recoveries, with fewer complications.

Where Can Outpatient Total Joint Replacement Be Performed?

Outpatient joint replacement can be performed in two main types of facilities—hospital operating rooms and ambulatory surgery centers, which are a type of outpatient facility.

Hospital operating rooms have historically been the primary location for these procedures. However, ambulatory surgery centers, which are designed specifically for outpatient surgeries, have gained popularity.

Some are housed within hospitals but function independently, while others are freestanding facilities. The choice of location often depends on individual patient needs and surgeon preferences.

Benefits of Outpatient Joint Replacement

The benefits of outpatient joint replacement include the following:

  • Less Pain: Patients experience less pain with the use of effective pain management techniques, resulting in a more comfortable recovery.
  • Lower Infection Rates: Outpatient environments typically have lower infection rates, reducing the risk of additional surgeries.
  • Faster Recovery at Home: Recovering in the familiar surroundings of one’s home promotes a sense of comfort and encourages a quicker return to daily activities.
  • Earlier Mobility: Patients are encouraged to move and walk around shortly after surgery, reducing the risk of complications such as blood clots, urinary retention, constipation, and pneumonia.
  • Higher Patient Satisfaction: Patients report high levels of satisfaction with the outpatient joint replacement process, appreciating the convenience and personalized care.

Preparing for the Outpatient Procedure

Successful preparation for outpatient joint replacement involves planning and coordination. Consider some possible steps you could take to prepare for outpatient joint replacement surgery:

  1. Creating a Supportive Home Environment: Patients may need to set up a home environment conducive to recovery, especially if they are having hip replacements or knee replacements, which may limit stair climbing.
  2. Scheduling Physical Therapy: For knee or shoulder replacement patients, scheduling the first few post-surgery physical therapy appointments ahead of time can aid in recovery.
  3. Mobility Aids: Patients undergoing hip and knee replacement should have canes and walkers at home for support.
  4. Comfortable Sleeping Arrangements: Shoulder replacement patients may find it more comfortable to sleep in a recliner or use a large wedge pillow to elevate their back in the weeks following surgery.
  5. Medications: Picking up prescribed medications, including pain relievers, blood thinners, and medications for nausea and constipation, in advance can ensure they are readily available post-surgery.
  6. Transportation and Support: Patients will not be able to drive immediately after surgery, so arranging for transportation to physical therapy and doctor appointments is essential. Having a friend or family member available for support is highly recommended.
  7. Meal Preparation: Preparing or arranging for meals is essential, as patients may not feel up to cooking immediately after surgery.
  8. Pain Management Options: Considering pain management options, such as continuous cold flow or cryotherapy systems, can enhance pain control and comfort during recovery.

Book Your Appointment Now

Our specialty-trained doctors at Orthopedic Specialists & Sports Medicine strive to give you the individualized, world-class care you deserve. Our Northpointe Surgical Suites facility has advanced technology and treatment protocols to ensure a rapid recovery.

We have been awarded the “Joint Commission’s Advanced Total Hip and Total Knee Replacement Certification” and are only the second ambulatory surgery center in Ohio to receive this distinguished certification.

To learn more about our outpatient total joint replacement procedures or to schedule an appointment with one of our doctors at our office in Granville or Coshocton, please call (740) 788-9220.


*A study in Becker’s ASC Review reports that ambulatory surgery center outpatient surgeries have a risk of complication as low as inpatient procedures and cost 40% less, with an average stay that is two-thirds shorter.

Medically reviewed by Brad L. Bernacki, M. D.