Outpatient Knee Replacement

In the summer of 2010, OSC’s Dr. Boyd Haynes worked with a patient to schedule her total knee replacement. The patient was a 52-year old female who was highly-motivated to return to her normal activity level. In the course of Dr. Haynes’ conversation about her surgery, she jokingly asked if she really had to stay at the hospital after her surgery. At that point, Dr. Haynes had been performing outpatient partial knee replacements for seven years. Dr. Haynes had been researching outpatient total knee replacements and found they were being performed at other surgery centers in the country, so we figured someone had to be OSC’s first outpatient total knee replacement! She ended up being the first AND she got her wish – her length of stay at the hospital was about 10 hours.

Since that first outpatient total knee replacement in 2010, we have spent a great deal of time developing an effective program to manage the recovery of this surgery at home. After that first procedure, we were confident this could be the wave of the future. It has been a natural progression to regularly perform the surgery in this manner to allow patients to recover in the comfort of their own homes. When we explore any new technologies or techniques at OSC, we always make decisions through the lens of, “would I want this for someone in my family?”

How is outpatient knee replacement possible?
Over the past several years, we have seen many changes occur that brought us to the point that outpatient total joint replacement surgery was possible:

– Advancement in surgical techniques
– Incisions are smaller, reducing likelihood of infection and pain
– Improvements in anesthesia allow for rapid recovery, shorter duration of care and the techniques used are more cost-effective.
– Pain management techniques have improved – we are using newer, longer lasting local anesthetics
– We have developed protocols for post-surgery home-health care, including nursing and physical therapy visits. Patients receive the same clinical care at home as they would in a hospital.
– Insurers began to cover it as an outpatient procedure

Patient Selection
We take patient selection very seriously. Not every patient who is interested will qualify. We look for patients who are very motivated to return to an activity level better than they had pre-surgery. We look for someone who is in reasonably good physical condition. It is also very important that the patient has a strong support system in their home. Recovering from major surgery is a full-time job, so it is imperative to have an extra set of hands and eyes to watch over you. We work with a home health company to provide nursing and physical therapy, but they are not in the patient’s home 24 hours a day.

What are the advantages to having this done as an outpatient procedure? There are several advantages to having this surgery performed on an outpatient basis:

– Less chance of acquiring an infection because patient spends less time in the hospital, and the incision is coated with a skin glue to seal it.
– Less financial burden– outpatient procedures are always less expensive, so depending on the patient’s insurance, out-of-pocket costs will be less. There is less burden on the insurance company and on the hospital staff.
– Recovery will be in the comfort of the patient’s home, which means more privacy, their own food and bed.
– Home health care will be pre-arranged, so the patient will know what to expect from the nurse and physical therapy.

In the past two decades, there have been significant advances in the world of orthopaedics and it is exciting to think about what the future holds for making patient’s lives easier. If you are experiencing significant knee or hip pain, please consider making an appointment at OSC to find out how we can help you. Call 757-596-1900 to make your appointment.