by: Kathleen A. Hogan, MD
When knee and hip replacements were first developed most patients would stay in the hospital for a minimum of a week, sometimes longer. This lengthy hospital stay was felt to be necessary for patients to get the physical therapy and the care they required for a full recovery. Today, this has changed. Most patients do not need to go to a nursing home for further rehabilitation and are able to return directly home after surgery. Most stay only 1-2 nights in the hospital, and some patients can actually go home the day of surgery.
Why is it Necessary to Be in the Hospital After Joint Replacement Surgery?
Certainly if a patient has diabetes, cardiac disease, kidney problems, sleep apnea or COPD it is important to be monitored closely for the first few days after surgery to ensure that there are no medical complications following surgery. But, what about someone without any of these medical problems? Do they need to stay in the hospital just for physical therapy? In the hospital, physical therapists work with joint replacement patients only once or twice a day. This could certainly be done at home.
But What’s Wrong with Staying at the Hospital for a Few Days?
Many people prefer the comforts of home to the sterile conditions of a hospital. While at the hospital, you may be exposed to patients who are sick with the flu or other illnesses. Bacteria found in hospitals is often resistant to many antibiotics. Nurses wake you up to check on you at night and control when you receive medication. Nurses will take care of several patients and may not be available immediately. Most common post-operative problems such as swelling, wound drainage, blood clots can be managed by your surgeon in the office if they occur. Hospital care is also very expensive; hospital and implant costs make up the majority of your bill.
Improved Pain Control Can Reduce Pain With Oral Narcotics
Hip and knee replacements can be painful. Improved pain control with the use of long lasting nerve blocks, multimodal pain management, and intra-articular injections can reduce that pain to a manageable level with oral narcotics. Rotator cuff repair and ACL reconstruction are also painful procedures that used to require a short stay in the hospital but are now outpatient surgeries.
Outpatient Hip and Knee Surgeries at a Surgical Center
Outpatient hip and knee surgeries are performed at a surgical center, not at the hospital. Many patients are ready to go home later that day. They can also stay overnight for observation and go home the next morning. Nurses teach patients how to use crutches or a walker. One nurse is assigned to a maximum of two patients. Physical therapists visit patients at home until they can travel to a therapy office. The surgeon is available for the patient to call if there are any questions or problems at home.
Not Every Patient is a Candidate for Outpatient Hip or Knee Replacement
Not every patient is a candidate for an outpatient hip or knee replacement. However, there is no need for lengthy hospital stays for healthy patients after joint replacement. For carefully selected patients, home Yixing Teapots can be a safer and more comfortable place to recover after surgery than the hospital.