Who is a Candidate

Alexander P. Sah

Outpatient total joint surgery is now being performed in specialized centers on select patients who are healthy enough to be candidates for this pathway.  I created and serve as Director of the Outpatient Joint Replacement Program at Washington Outpatient Surgery Center since 2014.  I am the only surgeon performing outpatient total joint replacements.  Patients have hip or knee surgery, and are able to go home the same day, after meeting goals and expectations to be safe at home.  Patients are therefore able to avoid staying in a hospital and are able to sleep in their own bed the night of surgery.  Patients often prefer to recover in the comforts of their own home.  These surgeries can be done at either an ambulatory surgery center or an inpatient hospital. This concept is relatively new, and orthopedic surgeons are still clarifying how to maximize the benefits of this idea for patients.

Outpatient total joint replacement should only be done on patients who are healthy enough to have surgery to allow a same-day discharge home.  Medical optimization, and absence of major heart, lung, or other systemic conditions are required.  Patient understanding of the goals and also having the ability to follow the recovery protocols are essential to success.  It is also critical to have the appropriate home setting and support system to facilitate outpatient surgery. 

The advantages of outpatient joint replacement include a reduced hospital stay, a possible reduced chance for hospital acquired infections, and the possibility of increased patient satisfaction. There is also potential for reduced cost to the health care system. The disadvantages of the outpatient joint replacement include the chance of having a complication at home, having difficulty with pain management, and the chance for readmission to the hospital. Orthopaedic surgeons agree that outpatient joint replacement is not for everyone, and actual peer-reviewed reports on the success of this approach are few with varied, but usually positive results.

Leadership Roles

  • Director, Outpatient Joint Replacement Program at IJR
  • Chair, Pain Management Ambulatory Surgery Center Task Force
  • Chair, Outpatient Total Joint Replacement Task Force