Outpatient Total Hip Replacement

Hip replacement surgery is one of the most common orthopedic surgeries performed. It involves the replacement of the damaged hip bone (ball shaped upper end of the femur) with a ceramic ball attached to a metal stem that is fixed into the femur and placing a new cup with a special liner in the pelvis. Traditionally, the surgery was performed with a large, open incision and required the patient to stay in the hospital for several days. With advanced techniques, it is now possible to perform these surgeries on an outpatient basis where the patient is up and walking a few hours after surgery and goes home on the same day. Outpatient hip surgeries use the same implants as traditional surgery but involve a smaller incision and newer exposure techniques when compared to the traditional procedures. This type of surgery is less invasive to the tissues and bones and involves a much shorter hospitalization time where the patient can go home the same day. 

Benefits of Recovering at Home After Surgery

Recovering at home means leaving the hospital setting and getting to recuperate in the comfort of your home. You will progress better in a familiar home environment where you are more likely to receive good care and a good night’s sleep.

Some of the benefits of recovering at home include:

• Convenience: The convenience of recovering in your home generally makes recovery time easier than an in-hospital stay.
• Lower cost: Since there are no hospital room charges and related hospital charges, costs are much lower.
• Reduced stress: You feel isolated in a hospital setting due to lack of social interaction that negatively affects your recovery. At home, family and friends can visit whenever they like and as often as you wish thereby reducing your stress level.
• Effective recovery: Home recovery is just as effective as in-hospital recovery. In fact, studies have found no significant differences in terms of complications, mobility, or pain in a home recovery.
• Safer: Home recovery is much safer compared to hospital stay as you are at risk of developing hospital-acquired infection (HAI) in a hospital setting no matter how sterile a hospital environment is.

Indication

Outpatient hip surgeries are mainly targeted at treating the joints damaged by arthritis and injuries. Chronic joint pain due to erosion of cartilage, damage due to accidents and autoimmune diseases, or bone death leading to the destruction of cartilage are also treated with the help of this surgery. 

Procedure

Outpatient hip surgery is designed to allow surgeons to replace the damaged hip bones through a small, minimally invasive approach. The single incision measures around 5 inches compared to 10 to 12 inches for traditional surgery and is usually placed on the outside of the thigh. The approach goes between the muscles and tendons to expose the hip socket and femoral head, similar to traditional surgery, but to a lesser extent. The head of the damaged femur is removed and the hip socket is cleaned. The stem and ball prosthetics are then fitted into the end of the femur and the cup is placed in the acetabulum without cement to achieve a biologic fixation. The hip is then rejoined and the surrounding tissues are brought back to the normal position. As the incision is very small, fewer muscles and tendons are traumatized. 

Postoperative Care and Instructions

After surgery, you will be transferred to the recovery area where you will rest until you are discharged. You will be given pain medications to ease pain. You may have to wear stockings to prevent blood pooling in your legs. You will be able to do light activities within a couple of weeks. You will also be given postoperative instructions, such as:

• Use of assistive devices for walking, such as cane or crutches
• Limited weight-bearing activities
• Suture and dressing care
• Physical therapy and exercise regimen to improve range of motion and strength muscles
• Dietary changes and supplements to improve bone health
• Adherence to prescribed medications
• Adherence to follow-up appointments to monitor your progress

Advantages of Outpatient Hip Replacement

The benefits of outpatient hip surgery are:

• Smaller incisions
• Less scarring 
• Less blood loss
• Shorter hospitalization
• Early return to work
• Shorter rehabilitation
• Less tissue trauma

Complications of Outpatient Hip Replacement

Complications are very rare and minimized with an experienced surgeon. Complications in outpatient hip surgeries mostly arise due to difficulty in performing the surgery within the restricted visual field. Some of the complications include tearing of skin and soft tissues, superficial nerve injury, and bone fracture during implant insertions.