Having hip- or knee-replacement surgery once meant you’d have a lengthy post-op hospital stay, followed by admission to a rehab center. Today, for many patients the surgery can be done in a procedure called a 23-hour joint replacement. This means you’ll have the surgery, spend one night in the hospital and then recover at home.
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A shorter hospital stay offers many benefits — including a quicker recovery. But a 23-hour joint replacement is not recommended for everyone.
Who’s a good candidate?
The best candidates for a 23-hour joint replacement typically are patients who need a hip or knee replacement who are younger and in overall good health, says orthopedic surgeon Kim Stearns, MD. That means those who are in a normal weight range and don’t smoke.
Even those who live alone may qualify. The key is to have support from family and friends while you recover.
“Older people, and those who are overweight, diabetic or have no resources at home don’t do as well,” he says.
How a 23-hour joint replacement works
Once a doctor determines that you qualify, he or she will schedule an early-morning surgery. You’ll get pain-blocking medicine and, by afternoon, a physical therapist will help you get out of bed and start walking.
The next morning you’ll undergo another round of therapy and likely head home after lunch. Your doctor will prescribe home care services, including a visiting nurse and visits from occupational and physical therapists.
Home health care providers will alert your surgeon’s office if they notice potential problems, he says. For instance, if they see that your wound is inflamed they’ll help get a prompt office visit arranged.
If there are no complications, you’ll see the doctor in about two weeks if you have a knee replacement, and in about four weeks after a hip replacement.
There’s no place like home
Even though you’re surrounded by medical professionals and state-of-the-art equipment in the hospital, you’ll typically recover better at home, Dr. Stearns says.
“Patients actually thrive more in their own home environment. The recovery is faster, the rehab quicker and the satisfaction greater,” he says.
And, not surprisingly, an overnight surgery costs “significantly less” than a two- to three-day or longer hospital stay.
When Dr. Stearns did his residency in the late 1980s, most joint replacement patients spent about three weeks in the hospital. Today, 85 percent of his patients are having replacements done with just one overnight hospital stay.
And the progress won’t stop there.
“Within the next year, we’ll start piloting a program for joint replacement patients to go home the same day,” he says.