Q & A with Dr. Jeffrey T. Hodrick, MD regarding Outpatient Joint Replacement. Dr. Hodrick is a Board Certified, fellowship-trained Orthopaedic Surgeon at the Southern Joint Replacement Institute in Nashville, TN.
What is Outpatient Joint Replacement? Outpatient joint replacement is when patients are discharged home the same day as their surgery. This is compared to inpatient surgery when patients spend at least one night in the hospital.
What makes Outpatient Joint Replacement possible? There have been several advancements in how we care for our joint replacement patients that make this a safe and successful option following surgery.
- Pain Management
- Blood Management
- Advanced Surgical Techniques
Anesthesia Patients receive a spinal anesthetic and sedation rather than a general anesthetic for their surgery. This allows the patient to breathe on their own and avoid having a tube placed in their throat. They also avoid inhaled anesthetic gases which is proven to reduce side effects such as nausea, vomiting, as well as lowering risk of bleeding and blood clots.
Pain Management We use a modern multimodal approach to treat our patients pain and to enhance their recovery after joint replacement. Total knee patients have a regional block which numbs the nerves over and around their knee. I inject pain medicine in and around the incision and knee during the surgery. Minimizing the need for strong pain medicines allows patients to be more awake, alert, and to avoid side effects of opioids. Patients typically walk 2-3 hours after surgery and are discharged home within 4-6 hours.
Blood Management Using advanced surgical techniques and tranexamic acid, a medicine that helps prevent blood loss, we have virtually eliminated the need for blood transfusion after joint replacement. Even more importantly, patients have less nausea, dizziness, and weakness immediately following their surgery. Patients have more energy in the days and weeks following surgery.
Advanced Surgical Techniques Using Robotic assisted technology allows me to be less invasive by minimizing the amount of soft tissue that is released during the surgery. This results in less inflammation and pain. Enhanced pre-operative planning as well the precision of the robot combine to optimize efficiency, the surgery and the outcome. Direct anterior hip replacement, compared to traditional techniques, avoids cutting muscle tissue or releasing tendons. This results in less pain and a faster recovery after the surgery. It is not unusual for my anterior hip patients to wake up feeling better than they did before the surgery.
Am I a candidate for Outpatient Joint Replacement? Most patients are candidates for outpatient joint replacement! I tell them they have earned the right to go home the same day because they have taken such great care of themselves. I believe patients do better, feel better, and sleep better in their own home. I have had many patients inquire about going home and avoiding a hospital stay during the COVID pandemic. Outpatient surgery is the answer!
Patients with significant heart, lung, kidney, or liver disease would not be good candidates for outpatient surgery. Patients with morbid obesity, poorly controlled diabetes, who smoke, or use chronic pain medicine are not ideal to go home the same day. These patients require pre operative optimization and can have their surgery while staying overnight in the hospital, allowing for observation.
If you would like to learn more about outpatient joint replacement surgery, please visit our website. If you would like to make an appointment to see Dr. Hodrick, please give us a call at 615-813-4230. www.nashvillehipandknee.com