Home in a day: Advances in joint replacement surgery

Hip and knee replacements have grown to become one of the most popular and successful elective operations ever performed. According to the Centers for Disease Control and Prevention, there were 1.1 million total joint replacements performed in the U.S. in 2012. Estimates show that by the year 2030, there’ll be 572,000 hip replacements and 3.48 million knee replacements performed annually in the U.S.

Given the high demand, hospitals are studying ways to best provide this care to patients. This is especially true at Anne Arundel Medical Center.

When I started doing joint replacement surgeries 13 years ago, the average length of stay for a patient who had hip or knee replacement was three nights. This is changing. Patients are going home sooner.

For instance, four years ago at AAMC, only 10 percent of patients who had hip and knee replacement surgery went home on the first postoperative day. This year in July, we saw 80 percent of patients who had a hip replacement, and 60 percent of patients who had a knee replacement, go home in one day. This includes a growing number of patients going home the same day of their procedure.

How is it possible to be discharged the next day, or even on the same day, after this type of procedure? The answer lies in a team approach always focused on the patient. There are a growing number of programs focused on helping speed up postoperative recovery, supporting early discharge and decreasing postoperative complications after joint replacement surgery. Locally, there is the Enhanced Recovery after Surgery (ERAS) program at AAMC.

Early on, we were concerned that with a shorter length of stay patients may need to come back to the hospital with medical or surgical issues, but this was not the case. Our data shows that earlier discharge does not increase re-admissions. With high-quality hip and knee replacement surgery, patients have a safe recovery — even when they go home on the day of surgery.

Advancing outcomes in joint replacement surgery

Hospitals and surgeons continue to engage in work to further improve joint replacement care. Here in Annapolis, the joint replacement team at AAMC is developing clinical programs to increase the number of patients who leave the hospital earlier and get on the road to recovery faster.

And by using predictive models, we’re able to better understand and choose patients who are good candidates for going home on the day of surgery.

Postoperatively, we’re working closely with physical therapists to develop protocols to use after surgery to accurately show when a patient is safely ready to go home.

Our efforts are focused on early recovery, to get you back to your own home and normal life sooner without hip or knee pain.

Author

James MacDonald, MD, is a joint surgeon at the Center for Joint Replacement at AAMC. To see the latest outcomes report from AAMC’s Center for Joint Replacement, visit askAAMC.org/JointOutcomes. To reach his practice for an appointment, call 410-268-8862.