Outpatient Joint Replacement: Our Study Looks at Trends and Safety

Outpatient hip and knee replacements are on the rise. Yes, increasing numbers of patients are going home the same day they have joint replacement surgery. We launched a study at Hospital for Special Surgery (HSS) to see if patients who went home the same day did as well as those who spent one or more nights in the hospital.

Analyzing information from a large database that included patients nationwide, we found no significant difference in complication rates for outpatient hip replacement. For knee replacement, we found slightly higher odds of complications in patients who left the hospital on the day they had surgery. Overall, though, complications were not common in either knee replacement group, with an incidence of less than 1%. The study appeared online in The Journal of Arthroplasty.

For our study, we were able to identify almost 1.8 million patients who underwent an elective total hip or total knee replacement between 2010 and 2017. We found that the annual rate of outpatient hip replacement and outpatient knee replacement increased exponentially from 2010 to 2017, with a mean annual change of almost 16% in the hip replacement group and 11% in the outpatient knee replacement group. Overall, patients discharged on the day they had surgery were younger and healthier, with fewer medical conditions such as diabetes and chronic pulmonary disease.


Good general health is essential for anyone considering outpatient joint replacement. People who have heart or lung disease, diabetes or sleep apnea would not qualify. They should be nonsmokers. Younger patients in their 40s or 50s and 60s tend to be better candidates, but people in their early 70s in very good general health may also qualify.

Individuals considering same-day discharge should feel comfortable forgoing a night in the hospital where they would receive nursing care. Anyone who feels very anxious about surgery or experiences a great deal of stress about recovery may not be a good candidate.

Our study concluded that same-day discharge joint replacement is safe, but requires additional patient monitoring in the early postoperative period. And although outpatient joint replacement can be performed safety and efficiently, it’s an option, not a requirement. Every patient is different, and individuals and their doctors should make an informed decision based on what makes patients feel most comfortable.

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