Same-Day joint replacement

Leaving the hospital the same day as a hip or knee replacement surgery has been a growing trend in the past 5 years. Though rehabilitation after joint replacement surgery takes time, the time you spend in the hospital doesn’t have to be overnight. This surprises many people. We’re here to answer some of the questions we most frequently get about same-day joint replacement.

What are the benefits of same-day joint replacement?

The biggest benefit is in the name itself: same day. This means you have the surgery early in the day and get to spend the night back in your own home.

How do I know if I’m a candidate for same-day joint replacement?

“Patients who are healthy at baseline with reasonably high level of function and good mobility can be potential candidates,” stated Kyle Hubler, DO, orthopaedic surgeon , who practices in North Central Pa. In general, people who are 70 or under and in good health are candidates (though patients over 70 aren’t automatically disqualified).

Other criteria include:

  • You have a body mass index of < 40
  • You can walk without assistance (cane only) prior to surgery.
  • You’ll have assistance at home during the recovery and rehabilitation period.
  • You don’t have any cardiac or respiratory diseases for which you need monitoring.
  • You don’t have untreated sleep apnea.
  • You don’t have chronic opioid use or an opioid addiction.
  • You don’t have any other condition that would prevent a same-day discharge.

If I need both knees or hips replaced, is it possible to do that same day?

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In some cases, same-day joint replacement, if you need both hips or knees replaced (called bilateral replacement), is possible. Also, revision surgeries to existing joint replacements are not done as a same-day discharge.

What has changed in the procedure to allow the patient to confidently go home the same day as the surgery?

Hip and knee replacement are two of the most common surgeries in the U.S. As we’ve done more and more of them, the surgery has become safer. Due to a medication called Transexamic Acid, patients lose less blood during the procedure allowing them to safely go home. Additionally, the use of local anesthesia nerve blocks and spinal anesthesias have improved pain control and shortened post-surgical recovery time. And most importantly, our data shows that patients can continue their recovery at home if they have the right support in place.

What does my surgery day look like if I get same-day joint replacement?

You will be scheduled for surgery early in the day (usually by 8 a.m.). This provides adequate time such that you can recover from the anesthesia and navigate the postoperative tasks and milestones you need to complete before leaving.

You will have at least 1 physical therapy session after surgery. If you pass the physical tests in that session, you are well on your way to being discharged in a few hours, following a meal, and successfully urinating.

Keep in mind that you will have spent the day before surgery doing “prehab.” This is when you learn about exercises you’ll need to do and how to use a walker. Completing all of your pre-surgery
education helps you focus on recovery the day of surgery.

Will my recovery period differ from a traditional total joint replacement?

We use a nerve block and spinal instead of general anesthesia for same-day discharge. You will be asleep but won’t need a breathing tube. Patients tend to recover more quickly from this type of anesthetic. But you’ll have the time you need to recover in the hospital and come out of the anesthesia.

Will I still do therapy before I leave the hospital?

Yes, rehabilitation therapy begins after surgery while you’re still in the hospital. It also continues at home for as long as needed, based on your goals. A nurse navigator will work with the patient at discharge to help to arrange outpatient physical therapy within a few days. This nurse navigator will continue to follow the patient along their rehabilitation journey. Same-day discharges receive the same amount of physical therapy in the hospital and at home as overnight stay cases.

Does discharging patients on the same day mean the hospital rushes through the surgery?

No, patients are never rushed. Neither is the discharge process. If you can meet all of the metrics for discharge, you can go home.

Could I be scheduled for same day but still have to spend the night?

Yes. If you don’t meet the discharge requirements, the hospital will keep you admitted for another day until you are able to be safely discharged.

Are the outcomes any different for traditional as opposed to same-day joint replacement?

“The outcomes for same-day discharge are every bit as good as they are for traditional,” Dr. Hubler said, “Patients who have same-day joint replacement surgery have low readmission rates and
complication rates on par with traditional overnight-stay patients.”

Does same-day joint replacement pose additional risks?

All surgeries carry risks, and your doctor will review all of them with you. For those who qualify, there are no more risks with same-day joint replacement than with joint replacement involving an overnight stay.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Orthopaedic Care

When you are dealing with bone, muscle, or joint pain, it can affect your daily life. UPMC Orthopaedic Care can help. As a national leader in advanced orthopaedic care, we diagnose and treat a full range of musculoskeletal disorders, from the acute and chronic to the common and complex. We provide access to UPMC’s vast network of support services for both surgical and nonsurgical treatments and a full continuum of care. Our multidisciplinary team of experts will work with you to develop the treatment plan that works best for you. Our care team uses the most innovative tools and techniques to provide better outcomes. We also are leaders in research and clinical trials, striving to find better ways to provide our patients care. With locations throughout our communities, you can find a provider near you.