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Getting a Hip or Knee Replacement? What You Need to Know About Ambulatory Joint Surgery

By Dr. Bruce Seideman and Dr. Kevin Cassidy

If you are experiencing hip or knee pain, you may be considering a total joint replacement. But did you know that it might be possible to undergo surgery at an ambulatory surgery center (ASC) and go home the same day?

About thirty years ago, it was common for a nearly two-week hospital stay after a joint replacement. Over time, it decreased to about two to five days in the hospital. Now, there’s another option available for certain cases – ambulatory joint surgery.

Ambulatory joint surgery is performed at an ASC, not a hospital, and patients go home the same day.

Patients can recover in the comfort of their own home with their loved ones. The benefits are numerous – you can sleep in your own bed in your own house in a quiet environment. When people are in control of their own recovery, it tends to go faster.

You may be a good candidate for ambulatory joint surgery if you are relatively healthy with no history of excessive narcotic use and have a good home support system. A strong support system is having at least one family member or friend to assist you at home – you don’t need to live in a ranch or an apartment building with an elevator. You will be able to walk up and down stairs when you are discharged. The ideal candidate is a motivated patient as recovery is a team effort between the patient and their medical team.

Every case is unique, but typically all partial replacements can be done as ambulatory, yet revision total joint replacements may not be best for this setting.

Research has recently shown that the safety of ambulatory joint replacements is equivalent to both a same-day discharge and an inpatient procedure in hospitals.

Your surgeon will not do anything different in the operating room if you are getting discharged same day versus staying overnight. There are no shortcuts – you will get the best care from your surgeon regardless of where the operation takes place.

A typical surgical day for an ambulatory joint replacement could look something like this:
– Operation takes place in the morning with a fast-acting spinal anesthesia
– About an hour after the procedure, a physical therapist will get you up and walking and teach you to do stairs
– Go home with a family member in the comfort of your own car by mid-afternoon

Patients overwhelmingly report that they are happy and comfortable their first night home.

We both perform ambulatory joint replacements at East Hills Ambulatory Surgery Center in Greenvale, which is affiliated with St. Francis Hospital & Heart Center®. This ASC was the first freestanding surgery center on Long Island – and one of the first in the New York City metro area – to do ambulatory total joint replacements. The anesthesiology team is the same at the ASC and hospital, so patients receive the same seamless care from an operating room team that has worked together for years. Your care team will utilize multimodal pain management from pre-op through to recovery.

The day after surgery, St. Francis home care sends a visiting nurse and physical therapist to your home where you have 5 days of PT (physical therapy) the first week, and 3 days the following week. After a total knee replacement, you will undergo PT for an additional month, all in the comfort of your own home.

We started doing outpatient total joint replacements regularly in 2019 (with volume increasing each year) and continue to be impressed at the success of these procedures. We consistently see higher patient satisfaction and a quicker return to normal daily life.

About Dr. Bruce Seideman
Dr. Seideman is a board-certified orthopedic surgeon at Orthopaedic Associates of Manhasset, P.C., specializing in hip & knee joint replacement/revision. He is focused on primary and complex revision total hip and knee replacement surgery as well as related disorders and arthritis of the hip and knee. He has been the chief of the joint replacement service at St. Francis Hospital since 2011.

About Dr. Kevin Cassidy
Dr. Cassidy is a board-certified orthopedic surgeon at Orthopaedic Associates of Manhasset, P.C., specializing in hip & knee joint replacement/revision. He is focused on the operative and nonoperative management of hip and knee arthritis, as well as complex primary and revision joint replacement.