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How Far We Have Come: Total Joint Surgery

Today’s patient comes home in three days

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Not so long ago, patients needing a total hip or knee replacement would be away from home anywhere from seven to 10 days – or even longer.

Often, that time would be split between the hospital (in an acute care setting) and a rehab facility (whether located in the hospital or in an extended care facility). Many factors contributed to this need for recovery and patient care after surgery. However, over the past few years, I have seen this change for the better.

Today, on average, patients are away from home after a total joint replacement for only three days. As a doctor, I am glad to be able to send my patients home on that third hospital day.

Is three days enough time in the hospital? You might think sending a surgical patient home early would increase the risk of post-op problems as well as re-admission to the hospital for post-operative complications.  While this may seem intuitive, many studies support less time in the hospital as a benefit for patients. I’ve also seen in my 20 years of practice that patients who go home earlier not only do better and progress through the post-op period faster, but they also have a lower post-operative complication rate.

What has changed to allow people to return home so quickly? As in so many innovations, it is not one specific change, but a few important, varied advances that work together to provide this dramatic benefit.

I’ve witnessed dramatic changes in medical, surgical and therapeutic techniques involved in a patient’s care from the morning of admission all the way to the discharge day.

This includes, but is not limited to:

  • Newer surgical techniques offering smaller incisions
  • Increased use of different anesthetic methods used together that target the part of the body being repaired – lowering the amount of overall sedation a patient needs
  • More aggressive, earlier start to physical therapy in the hospital
  • More nursing care directly involved in helping a patient move around or begin to walk in the immediate, post-op period

Together, these efforts have resulted in faster recuperation for the total joint patient.

More information

What We Treat: Musculoskeletal Impairments
Total Hip Replacement 
Total Shoulder Replacement 
Online Chat Transcript: Advances in Hip and Knee Surgery 
Online Chat Transcript: Advances in Knee Replacement Surgery 
Online Chat Transcript: Joint Replacement

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Tags: arthritis, joint pain, joint replacement, knee pain, orthopaedic, physical therapy

Joseph Scarcella, MD, Orthopaedic Surgery, Cleveland Clinic, has been in practice for more than 20 years in southwest Cleveland hospitals.

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  • Nicole Campbell

    Dr. Brooks saved my husbands life at the Cleveland Clinic. He did not send him home after three days. He prescribed him to the best rehab Dr. On this planet. He still has a permanent disability tag which he refused then and now keeps as a reminder to pray for the Doctors that saved his life. He needed every minute of his rehab not in some home hospital that refused maybe because they were not capable and they knew it to help him in the first place. #dr.brooksclevelandclinic

  • Jon

    I agree with the new innovations w/ surgery but I’m sure the insurance companies will only cover so many days in the hospital