Same-day Discharge for Hip Replacement?

You’ve been told you need a hip replacement, and you’re concerned about what that means in terms of recovery and time away from home and work. You are surprised when your doctor says you can come home the same day as your surgery—no need to even go to a hospital. Today’s hip replacement surgery is very different from that of several years ago. Same-day discharge from ambulatory surgery centers (ASCs) has replaced overnight or longer hospital stays, according to Dr. John T. Dearborn, orthopedic surgeon, founder and co-medical director of Washington Hospital’s Institute for Joint Restoration and Research (IJRR).

Several studies have shown that hip replacement performed at an ASC is as safe—and potentially safer—than the same surgery performed in a hospital. Improved surgical techniques and postoperative pain management have made the ASC the preferred location for most patients.

Dr. Dearborn will discuss hip replacement surgery and recovery on Wednesday, Nov. 20, with an online Health & Wellness seminar. The 9 a.m. seminar, titled “Safely Home After Hip Replacement,” can be accessed on Facebook.com/WashingtonHosp and on YouTube.com/whhsinHealth.

“Most of my patients, up to the age of 80 or so, qualify for outpatient hip replacement surgery,” Dr. Dearborn notes. Certain health conditions, such as severe heart, lung, or kidney issues, may dictate surgery in a hospital setting. He adds, “But for most hip replacement candidates, surgery at an ASC is at least as safe as having the procedure performed at the hospital.”

Of course, all patients will need some assistance at home initially and may require physical therapy to regain strength and flexibility in the hip. Most patients can resume modest activity—working at a desk, light housework, walking, etc.—within two weeks of the surgery, Dr. Dearborn says. At least six weeks are required to resume heavier physical work, and longer for most sports.

The major shift to same-day discharge at Washington Hospital started in 2020, at the beginning of the COVID-19 pandemic. Patients needing hip replacements did not want to spend the night at a hospital, preferring to spend the first postoperative night in their own bed in the safety of their own homes. In response to this rising demand, Peninsula Surgery Center (PSC) was developed during the early pandemic, recreating the already successful program at Washington Hospital into a purely outpatient model. Same-day discharge hip replacement is now performed at both Peninsula Surgery Center in Redwood Shores and the Washington Outpatient Surgery Center in Fremont. To date, every hip replacement patient at PSC has been successfully discharged home the same day.

Keys to successful same-day surgeries include thoroughly defined pre- and post-surgery plans. The pre-surgery plan should focus on a balanced, protein-rich diet to promote wound healing, muscle tone/cardio exercises to build up arm and leg strength, and a thorough pre-operation examination with one’s primary care physician. A post-surgery plan should include someone to assist the patient at home for a few days, postoperative home-based physical therapy, and a next-day follow-up call from a nurse.

Same-day hip replacement surgery is a safe route to a smooth and quick recovery. “Continued improvement in surgical techniques and perioperative pain management ensure better outcomes and faster recoveries now and in the years ahead,” notes Dr. Dearborn. “I encourage anyone facing hip replacement surgery to consider having their procedure at an ASC.”

To learn more about Dr. Dearborn, visit the Meet Our Team page at whhs.com/IJRR.