Outpatient Knee Replacement

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.

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.

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.

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.

My name is Dr. Suhirad Khokhar, and am an orthopaedic surgeon. I completed my MBBS (Bachelor of Medicine & Bachelor of Surgery) at Govt. Medical College, Patiala, India.

I specialize in musculoskeletal disorders and their management, and have personally approved of and written this content.

My profile page has all of my educational information, work experience, and all the pages on this site that I've contributed to.