What is outpatient joint replacement?

Outpatient total joint replacement is performed in a clinical environment rather than in the hospital. And patients go home the same day. There are many reasons for this.

Better pain control

• Epidural injections numb the hip or knee area for replacement procedures.
• Shoulder replacement surgery can be done with brachial plexus injections.
• Local anesthetics offer longer-lasting pain relief and reduce the need for opioid medications.

Additionally, multimodal pain control involving the use of several medications such as acetaminophen, or NSAIDs such as iboprofen, reduce or eliminate the need for narcotics and opioids. This results in safer pain control so patients can recover safely at home.

Advanced surgical techniques

These advances have shortened surgical procedures drastically and reduced blood loss. They can also be less invasive and therefore less traumatic for the patient. Additionally, medications such as tranexamic acid (TXA) further reduce blood loss and make transfusions less necessary after total joint replacement surgery.

Advanced pre-operative safety and patient selection

The surgeons at the Orthopedic Performance Institute apply advanced pre-screening techniques to identify the patients that are eligible for outpatient surgery, and which patients should stay overnight at a hospital after surgery. Eligibility is based on these factors:

• Age
• Pre-existing health conditions (heart disease, lung disease, kidney disease, etc.)
• Home environment and safety
• Support from family

More immediate physical therapy and occupational therapy

Gone are the weeks spent waiting for patients to heal. It’s been proven that getting a patient out of bed and walking the same day of surgery — even a few hours later — results in faster recovery time with fewer complications

Where is outpatient surgery performed?

There are two types of facilities utilized for the procedure:

• Hospital operating rooms. Historically, most total joint replacements have been performed in the hospital environment.
• Ambulatory (outpatient) surgery centers. Some of these centers are found in hospitals but function independently. Others are free-standing, occupying buildings of their own.

Surgeons Matthew Dwyer, MD and Christopher Phelps, MD, of the Orthopedic Performance Institute utilize both environments, depending upon patient needs, insurance coverage, or availability. Either way, patients can rest assured that they’ll be treated with the same level of skill and receive excellent care in either environment.

Ambulatory surgery centers provide:

• Pre-op areas to prepare patients for surgery
• Operating rooms where surgery is performed
• Post-surgery recovery areas

When a patient is fully recovered from the anesthesia, they are picked up by a friend or family member and driven home that same day.

Is outpatient total joint replacement surgery safe?

Again, studies show that it’s safer than staying in the hospital and patients have reported higher satisfaction rates.

What risks are involved?

We will prescreen you to determine which environment is safer for you. As mentioned above, if your health is compromised (i.e., heart, lung and kidney disease), then hospitalization may be recommended.

What are the benefits of outpatient total joint replacement?

• Reduced pain
• Lower infection rates, which means a lower risk of needing additional surgery
• Quicker recovery in the comfort of your own home
• Faster mobility with less time spent in bed, helping to reduce blood clots, urinary tract infections and pneumonia
• Increased satisfaction with the joint replacement process

What do I need to do to prepare for the procedure?

As they do with their traditional in-hospital surgical procedure preparations, the staff at the Orthopedic Performance Institute will provide a pre-surgery class to tell you what to expect and answer your questions. They’ll also recommend the pre-surgery exercises you should perform.

Stop living with pain! Find out if you are a candidate for outpatient total joint replacement surgery. Contact the Orthopedic Performance Institute at (210) 545-7171.

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Knee or hip joint replacement, also called arthroplasty, can be a valuable tool when traditional, non-surgical treatment options have failed to manage the pain from an arthritic hip or knee.

Osteoarthritis, the most common form of arthritis, is a progressive, degenerative disease in which the cartilage of the knee or hip slowly wears away. Cartilage serves as a cushion between the bones of the joint, and when the cartilage of the joint wears away due to osteoarthritis, the resulting pain and inflammation can be debilitating.

Your chances of osteoarthritis of the weight-bearing joints of the knee and hip increase with age; the condition most often affects middle-aged and older people. Osteoarthritis may first appear between the ages of 30 and 40, though symptoms may not be present in the early stages. Later in life, many Americans will experience joint pain due to arthritis that can make enjoying life very challenging.

Orthopedic surgeons, Dr. Matthew Dwyer and Dr. Christopher Phelps, with the Orthopedic Performance Institute, are dedicated to combating the effects of osteoarthritis and are determined to guide patients back to an active, enjoyable lifestyle.

Historically, knee and hip replacement have been Performed as in-patient procedures, involving one or even two-night stays in the hospital. Since 2018, both Dr. Dwyer and Dr. Phelps have been performing joint replacements on an out-patient basis. This is accomplished through extensive patient education and preparation combined with minimally invasive surgical techniques, advanced pain management therapies and enhanced rehabilitative support.

Our outpatient total joint replacement program eliminates the need for overnight hospital stays and allows patients to return to an active, enjoyable life with minimal downtime. The surgery itself takes about one and a half hours, and patients spend about five to six hours total at the surgical center before being discharged to recover fully at home.

The success of outpatient joint replacement journey is dependent on several factors. One of the most imperative factors is appropriate patient selection which can be based on good general health, age, and at-home support, followed by preparation and education of the patient about:

• At-home rehabilitation and post-operative exercise.
• Wound care and pain management.
• Recognition and avoidance of possible complications. Complications such as infections or blood clots are associated with any surgery, and precautions are taken to minimize these concerns.

Dr. Dwyer and Dr. Phelps have a genuine commitment to patient health and have performed hundreds of successful joint replacement surgeries each year. For more information about knee and hip replacement surgery or any orthopedic condition, call (210) 545-7171 or visit our website. The Orthopedic Performance Institute has offices in Stone Oak and Boerne.

Get back your active life with the Orthopedic Performance Institute.

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