Health Essentials from Cleveland Clinic

Total hip and knee replacements have come a long way. Afterwards, people no longer lay in a hospital bed for three weeks; instead they generally begin walking at home within a day of the procedure.

Of course, recovery still takes time. But it may surprise you to see how quickly that time passes after outpatient surgery, which is an option for some people.

If your doctor says you’re a good candidate, there are several advantages that make outpatient surgery the best option, says orthopedic surgeon Trevor Murray, MD.

1. Less pain

You won’t need a pain pump for self-administered medications or IV pain killers with outpatient surgery.

Instead, you’ll get a spinal injection that numbs you from the waist down for two hours. A long-lasting local anesthetic will help control your pain for up to two days afterward.

2. Fewer transfusions

Patients are less likely to need blood transfusions because of better surgical technique, better patient optimization, and the use of tranexamic acid transfusions; these factors also allow surgeons to perform hip and knee replacement procedures as an outpatient procedure.

3. Lower infection risk

Spending less time in the hospital lowers the chances of infection in your surgery site.

“I tell my patients, the hospital is full of people who are sick, and post-surgery patients aren’t sick,” Dr. Murray says. “I like to get them away from all that.”

4. Better recovery at home

Leaving the hospital means you get to recuperate in the comfort of your own home. You’ll progress better in a familiar environment where you’re more likely to get a good night’s sleep.

5. Faster, more aggressive physical therapy

A physical therapist begins working with you the day of surgery or within a day of you returning home. He or she will help you exercise to regain full function in the joint.

Are you the right patient?

In a total knee or hip replacement, the surgery itself is the same for both inpatient and outpatient options.

But, you’re a strong candidate for outpatient surgery if you are:

• Motivated. A positive attitude and willingness to follow your doctor’s post-surgery instructions will increase the likelihood of a good outcome.

• Mobile. If you’re active and independent before surgery, you’ll automatically respond better to physical therapy. And you’ll resume your daily activities more easily, Dr. Murray says. However, if you use a walker or wheelchair before surgery, an inpatient procedure is likely your best option.

• Healthy. The fewer medications you take or ailments you have, the better outpatient candidate you are. If you take medications for chronic pain, for example, your surgery may be better suited in an inpatient setting.

• Supported. Having a wider social network — meaning, several friends and/or family members who can help you after surgery — will make your recovery faster and better.

Ultimately, Dr. Murray says, your knee or hip replacement outcome will likely go better than you anticipate.

“Patients are going to end up doing better and being more independent than they expect,” he says. “But, they must be engaged and have someone around to help for several weeks post-surgery.”