Outpatient Total Hip Replacement Surgery

Hip replacement surgery is a common treatment for severe arthritis of the hip joint. In recent decades, hip replacement surgery has become much more common. Once reserved for elderly, inactive patients, many surgeons now perform hip replacements on young, active patients who are looking to maintain their busy lifestyle.

As hip replacement surgery has evolved, techniques and protocols have been developed to make this procedure less invasive. The goal of any minimally invasive procedure is to try to make patients better, faster, and with less disruption to their life.

Most recently, many patients are now choosing to have an anterior hip replacement, a surgery intended to have less muscle damage and a faster recovery. In an effort to further the ability to get patients back to normal as quickly as possible, some surgeons have started to perform hip replacement surgery as an outpatient procedure.

Why Patients Stay in the Hospital

The first question to ask about outpatient hip replacement surgery is, why do patients stay in the hospital at all after traditional hip replacement? There are a few reasons, and if outpatient surgery is to be considered, then these reasons must be addressed.

• Fear: Many patients undergoing hip replacement surgery have anxiety and concerns, specifically related to how they will be able to function after surgery. If a patient shows up for surgery knowing little about their upcoming procedure and what they will need to function independently at home after surgery, they will likely have a hard time with outpatient surgery. There are ways to educate and prepare patients for surgery so they can safely return home.
• Pain: Pain can be a concern for patients having major surgery such as a hip replacement. Methods for pain control have dramatically improved, and minimally invasive techniques cause less discomfort after surgery. Long-acting nerve blocks, local anesthetics, and new pain medications can all help patients better manage pain after a joint replacement.
• Function: Some patients will be better able to manage independently after joint replacement than others. Healthy, lighter-weight, stronger patients can better support themselves during and after surgery. Careful selection of patients is necessary before considering outpatient joint replacement.

The Risks of Outpatient Joint Replacement Surgery

There are risks of joint replacement, and not every patient is a good candidate for this surgical procedure. Only patients who have excellent overall health, and sufficient upper body strength to function independently, will be considered for outpatient total hip replacement.

There are very limited data, but there is no current evidence that common risks of hip replacement are higher for patients after outpatient hip replacement surgery. In fact, some surgeons would argue that the early mobilization may help to reduce risks of complications such as blood clot after a joint replacement.

Bottom Line: Is It Safe?

Current evidence suggests that outpatient hip replacement surgery is safe in carefully selected patients. Patients should be healthy and strong, and they must be well-prepared for the post-surgical management at home. There is a significant amount of education involved in preparing patients for outpatient surgery, and these patients should have help at home in the days after surgery.

In addition, note that at present Medicare does not allow for patients to have an outpatient hip replacement. Most commercial insurers will allow for this surgery, however.