It is possible for a patient to be safely discharged home the same day after partial or total knee replacement surgery, without ever being admitted to a hospital. Outpatient knee replacement currently accounts for only a small percentage of all knee replacement surgeries in the US, but experts believe it will become more common over the next decade.,

The Trend Toward Shorter Hospital Stays

Decades ago, hospital stays following knee replacement surgery were about 10 days. Now, typical hospital stays range between 0 and 3 days. This trend is the result of several changes, including:

  • Advancements in knee replacement surgery—for example, current surgical procedures call for the use of tranexamic acid, a medication that helps minimize blood loss

    See Total Knee Replacement Surgical Procedure

  • A better understanding of the medical risks associated with surgery and the development of ways to minimize those risks and associated complications

    See Total Knee Replacement Risks and Complications

  • Improvements in identifying who will recover well after surgery versus who might be at high risk for specific postsurgical problems and who should avoid surgery altogether

    See Total Knee Replacement Surgery Recovery

  • Better and more predictable anesthesia and pain control methods that can improve comfort, minimize side effects (such as nausea), and speed recovery

    See Anesthesia for Orthopedic Surgery

  • Many more younger, healthier patients undergoing knee replacement surgery

Improved patient education via print materials, video, and even smartphone apps that help prepare patients and their caregivers for recovery, has also facilitated the trend toward outpatient surgeries.

See What to Expect After Knee Replacement

advertisement

Is Outpatient Knee Replacement Safe?

Most current research suggests that outpatient knee replacement, for the properly selected and prepared patient, is as safe as inpatient surgery., For these select patients, while there may be a trade-off in potential risks, there is no evidence of an overall statistical increase in risks.

Does outpatient knee surgery take place in a hospital?
Outpatient knee replacement can take place at a hospital or an ambulatory surgery center.

An ambulatory surgery center is a health care facility specifically designed for outpatient surgeries. Many—but not all—of these centers are certified by Medicare and/or hold other professional accreditations.

Plans for early discharge can change
Rarely, plans for a same-day discharge must be cancelled and the patient is observed overnight in the ambulatory surgery center or is admitted to the hospital.

advertisement

Reasons for observation or admission may include difficulty controlling pain, urinary retention, nausea and/or vomiting, significant blood loss during surgery or low blood pressure. These signs do not necessarily indicate medical complications; however, they are signs that the patient needs extra time to recover before being sent home.

Dr. J. Stuart Melvin is an orthopedic surgeon specializing in orthopedic trauma and joint replacement surgery. He practices at Washington Orthopaedics and Sports Medicine. Dr. Melvin is a reviewer for the Journal of Arthroplasty, has contributed chapters to several medical textbooks, and has had numerous scientific papers published in academic journals.

advertisement
advertisement