Outpatient Knee Replacement

Knee pain is a common problem for many people. Severe pain or discomfort that affects daily activities or comes with swelling, redness, or warmth should be evaluated by a healthcare provider.

At Complete Orthopedics, our specialized team is equipped to handle all types of knee pain, offering surgical treatments when necessary. We serve New York City and Long Island with six hospital locations, providing excellent surgical and orthopedic care. You can schedule an appointment with our expert surgeons online or by phone.

Discover the common causes of knee pain and explore the treatment options we provide, including when surgery might be required.

Overview

Outpatient knee replacement means the patient can go home the same day of the surgery. Traditionally patients without any complication may stay in the hospital for up to 3 days after the surgery.

The outpatient knee replacement is made possible with a multidisciplinary team that works to ensure patient safety. While outpatient knee replacement surgery offers several advantages, outpatient surgery is not suited for all patients.

Knee replacement surgeries are being performed in more and more numbers owing to the success and advancement of arthroplasty technology. The surgery is performed when all nonsurgical methods of treatment have failed to help patients with knee arthritis.

Postoperative X-ray showing a total knee replacement.

Besides the elderly, a large number of young patients are undergoing knee replacement surgery. An increased number of patients no longer delay replacement surgery as they demand a lifestyle free of pain and deformity. With the advent of newer knee implants and techniques, knee replacement surgeries today last for 20 years or more.

Outpatient knee replacement has been made possible due to a better understanding of the risks associated with knee replacement surgery and its management. The orthopedic physicians today work with pain management specialists and anesthesiologists to better predict and manage the pain after the surgery.

The introduction of medications such as Tranexamic acid has reduced the amount of bleeding occurring during and after the surgery. The operative practices and the techniques in knee replacement have reduced the chances of prosthetic joint infection to a minimum.

However not all patients are candidates for an outpatient knee replacement surgery and the patients are offered an outpatient surgery only after careful assessment by the surgeon, anesthesiologist, pain specialist, nurses, and therapists.

• Ideal outpatient knee replacement candidates have a strong social support system at their homes. Patients may often need help moving about at home and to help them deal with any potential complications.
• Patients need to be strongly motivated for outpatient knee replacement surgery. A strongly motivated patient is able to follow the at-home instructions and may tolerate the at-home care better than others.
• Ideal patients are aged less than 70 years and are free from any major medical illnesses such as heart or lung disease, vascular disease, or any neurological disease. Patients with any heart disease such as coronary artery disease or COPD are at an increased risk of complications following the surgery.
• Patients who are current smokers, who abuse alcohol, illicit drug users, or with a history of use of opioid analgesics are poor candidates for outpatient knee replacement surgery. Such patients may have an unpredictable pain response after the surgery and are better managed by in-hospital stay after the surgery.
• The housing of the patient should have a safe environment for immediate postoperative rehabilitation. Ideally, the patients living quarters should be on the same floor along with the bathroom and kitchen. Safe housing is important to prevent any falls after the surgery.
• Patients with a history of depression/anxiety are not ideal candidates for outpatient knee replacement surgery.
• Obese patients with a BMI of more than 30 may not be advised outpatient surgery.

Benefits of Outpatient Knee Replacement

Several benefits are associated with outpatient knee replacement:

Faster Recovery: Patients can start their recovery in the comfort of their own home, which can lead to a quicker return to normal activities.

Lower Risk of Infection: Spending less time in the hospital reduces the risk of hospital-acquired infections.

Cost-Effective: Outpatient procedures can be more cost-effective for both patients and healthcare providers due to the reduced need for hospital resources.

Patient Satisfaction: Many patients prefer recovering at home, which can enhance their overall satisfaction and comfort.

Outpatient knee replacement surgery offers several advantages for the right candidates. The outpatient surgery can minimize the risk of the postoperative surgical site/wound infection. In a hospital setting, the patient may potentially be vulnerable to catch a resistant infection from another patient or a healthcare provider.

The patients report greater satisfaction while being at home after surgery. The home environment is reassuring to the patient and the movement in a familiar environment promotes an early return to activities. The patients also report greater participation in therapy and exercises in the comfort of their own homes.

The outpatient surgeries are also associated with a decrease in the cost of the procedure and reduce the burden on the healthcare system while not compromising with the care of the patient. The patients are constantly monitored after the surgery and are allowed to walk with support the same day.

Intraoperative cocktail for peri-articular injection used for pain control after the surgery.

The patients are thoroughly instructed before they can sit in a car to go home. At home, a trained nurse and a therapist monitor the patient’s progress. At any step should the need arise, the patient may be admitted to the hospital. The nurse constantly takes care of the operative dressing.

Some patients may not feel comfortable going home the same day of the surgery and they are supported in their decision to stay at the hospital. Hospital stay offers the patient the advantage of constant monitoring and the ability to manage any complications should they arise.

With the success of knee replacement surgeries, a large number of young patients may today opt for an outpatient knee replacement surgery that may be performed in a hospital or an ambulatory surgical center. Speak with your surgeon regarding the best options should you require knee replacement surgery.

How is Outpatient Knee Replacement Performed?

The procedure for outpatient knee replacement is similar to traditional knee replacement but with a few key differences to facilitate a quicker discharge. Here’s an overview of the process:

Preoperative Preparation: Patients undergo thorough preoperative assessments to ensure they are suitable candidates for outpatient surgery. This includes evaluating their overall health, home environment, and support system.

Anesthesia: Regional anesthesia, such as a spinal or epidural block, is commonly used to minimize pain and reduce the need for general anesthesia, which can prolong recovery.

Surgical Technique: The surgeon performs the knee replacement using minimally invasive techniques, which involve smaller incisions and less tissue damage. This approach helps reduce pain and speed up recovery.

Postoperative Care: After the surgery, patients are closely monitored in a recovery area. Pain management is a priority, and patients are encouraged to start moving their knee as soon as possible.

Discharge: Once the patient meets specific criteria, such as stable vital signs, adequate pain control, and the ability to walk with assistance, they are discharged home with detailed instructions for home care and follow-up appointments.

 Recovery

Recovery from outpatient knee replacement involves several stages, and it’s important to follow your surgeon’s instructions closely. Here’s what you can generally expect:

First Few Days: The initial days after surgery are crucial for pain management and preventing complications. Patients are advised to take prescribed pain medications, keep the surgical area clean and dry, and start gentle movements to avoid stiffness.

Physical Therapy: Early physical therapy is essential for regaining mobility and strength. A physical therapist will guide you through exercises to improve knee function and flexibility.

Follow-Up Appointments: Regular follow-up visits with your surgeon are necessary to monitor your progress and address any concerns. These appointments help ensure that your knee is healing correctly.

Resuming Activities: Most patients can return to light activities within a few weeks, but it may take several months to fully recover and resume more strenuous activities. Your surgeon and physical therapist will provide guidance on when it’s safe to return to work, sports, and other activities.

Conclusion

Outpatient knee replacement is a promising option for many patients suffering from severe knee pain and disability. With the potential for faster recovery, lower infection risk, and cost savings, it offers a viable alternative to traditional inpatient surgery. However, it’s important to carefully consider your individual circumstances and consult with your healthcare provider to determine if this approach is right for you. By understanding the process, benefits, and what to expect during recovery, you can make an informed decision and take an active role in your knee health journey.

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