by Dr. Patrick Boyett, Joint Replacement Surgeon with TOC – The Orthopaedic Center Athens
Outpatient total joint replacement surgery is a regular joint replacement surgery that happens in a surgery center instead of a hospital, and the patient goes home the same day.
What are the benefits of outpatient joint replacement surgery?
Studies are suggesting that outpatient knee and hip surgery result in less risk of blood clots and infections compared to patients who have their surgery in a traditional hospital visit. Hospital stays have become shorter and shorter because of better pain control adjuncts, improved surgical approaches, and improved procedures to assist recovery. Less invasive surgical approaches, improved instruments, and more surgical techniques have impacted the ability to safely perform outpatient joint replacements. Improved techniques such as Direct Anterior hip replacement, minimally invasive instruments for knee replacement and partial knee replacement, and short stem shoulder implants have revolutionized incision size, muscle damage during surgery, and recovery in a positive fashion. Even the operating room bed that we use now to perform hip replacement surgery is made of carbon fiber and allows x-rays to be used during surgery to enhance the accuracy of implant size, position, and leg length. New surgery tools that we utilize result in less pain and less bruising at the end of surgery. Anesthesia options with cleaner medications and shorter duration of actions allow patients to wake up clearer and with fewer side effects. It has been clear for quite some time that early motion and activity with less exposure to other sick patients results in a smoother recovery. Our patients now walk within 2 hours of surgery.
How has joint replacement surgery evolved?
Outpatient joint replacement surgery has evolved over the past five years from being an extensive hospital stay to same-day discharge that can be accomplished in our Surgery Center safely and efficiently. In the old days, orthopedics used PCA pumps, which were administered pain pumps that used heavy narcotic pain medications such as morphine. Although these medications assisted with pain control, they had problematic side effects, such as constipation, drowsiness, weakened respiratory drive, lethargy, confusion, and ultimately increased complications and negatively impacted recovery.
Who is the ideal candidate for outpatient joint replacement surgery?
The typical outpatient joint replacement candidate is a healthy, active patient who has a good family or friend support system.
Where do outpatient joint replacement surgeons perform their surgeries?
From the concept to development to building of the Athens/TOC Surgery Tower, the idea of having a 28,000-square-foot clinic and physical therapy space in the same building as the Surgery Center was always anchored by the idea of having outpatient joint replacement. The facility was built with this concept in mind and is uniquely positioned to be the best outpatient joint facility in North Alabama.
What can a patient expect when they schedule outpatient joint replacement surgery?
A coordinated system. Outpatient joint replacement surgery of the knee, hip, and shoulder requires a coordinated team to afford a more informed patient and family of expectations while providing comfort and knowledge in the recovery. At TOC Athens, we use a Joint Camp education approach, where patients meet our Orthopedic Navigator, Director of Physical Therapy, specialized orthopedic nurses, and discharge planners before their surgery, which makes the patient part of the team early in the process. This has proven to streamline the recovery process and allows us to answer questions before they become concerns.
Effective pain management. Currently at TOC Athens, we perform an intra-operative block in the joint that uses liposome technology. This means that local pain medication like you might receive at the dentist is encapsulated in a fat bubble and released slowly into the tissues surrounding the joint. This provides excellent pain control for approximately 48 to 72 hours without the side effects you might expect from narcotics. Over 90% of our patients now use only oral pain medications and no longer deal with the side effects of IV pain meds.
In summary, outpatient joint replacement is now a reality and has become a routine, yet exciting part of our practice. To discover if you are a candidate for this innovative approach to joint replacement as an outpatient, schedule an appointment and discuss this with your TOC Athens surgeon, Dr. Patrick Boyett, Dr. Bill Lawrence, or Dr. Eric Stanford.
About Dr. Boyett
Dr. Patrick Boyett is a board certified orthopedic surgeon with a focus on minimally invasive joint replacement and arthroscopic sports medicine procedures. Dr. Boyett performs most of his surgeries at the Surgery Tower located in the Athens TOC tower, which is poised to be a premier facility for outpatient joint replacement. He works with an operating team that collaborates to improve outcomes and recovery. Dr. Boyett performs outpatient Joint Replacement surgery for patients who meet the criteria for outpatient joint replacement. The highest priority when preparing for surgery is to minimize infection risk. This is achieved through preoperative screenings, preoperative patient scrubs, and antibiotics before and after joint replacement surgery. His team then coordinates recovery with Physical Therapy, which gives his patients a more comprehensive recovery.
Sudhakar Madanagopal, MD
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