Same Day Hip Replacement Surgery | Minimally invasive hip replacement
Many people that we see with hip pain are in our offices because they are exploring options to an already recommended traditional hip replacement surgery. Two of the options they are exploring to their hip replacement recommendation are a same day hip replacement and Prolotherapy and/or stem cell therapy. In this article we will present information on these options.
The idea of same day hip replacement certainly has its appeal. It also has some misconceptions. Many people believe the same day hip replacement is a walk into the hospital in the morning and they walk out at night with a new hip without further ado. Of course this is not how the procedure works. There is preparation for the surgery and there is rehabilitation from the hip surgery. For many, it simply means a smaller surgical incision and getting out of the hospital faster. Who can argue with that? Concerned surgeons for one.
The realistic expectation of same day hip replacement: Same day hip replacement is not right for everyone
In the medical journal Clinical Orthopaedics and Related Research, doctors at the Anderson Orthopaedic Research Institute & Inova Center for Joint Replacement at Mount Vernon Hospital, Virginia, and The Rothman Institute & Thomas Jefferson University Hospital, in Philadelphia provided these insights into the same day hip replacement procedure:
- “Patients should understand that published studies that have examined same-day and early discharge protocols after total hip replacement have been done in highly selected patient groups operated on by senior surgeons in a nonrandomized fashion without control subjects.”
- In other words: published studies are issued on only the patients that have the best chance of success. Same day hip replacement is not right for everyone.
The supportive research findings:
- The purpose of this study was to evaluate and compare patients undergoing total hip replacement who are discharged on the same day as the surgery. Those called “outpatients” who were in the hospital less than 12 hours with those who are discharged after an overnight hospital stay (“inpatient”) with regard to the following outcomes:
- (1) postoperative pain;
- (2) perioperative complications and healthcare provider visits (readmission, emergency department or physician office); and
- (3) relative work effort for the surgeon’s office staff.
Who is a good candidate for same day hip replacement?
The researchers then identified who would be a good candidate for the procedure.
- Patients who were younger than 75 years of age at surgery,
- who could ambulate (walk) without a walker,
- who were not on chronic opioids, and
- whose body mass index was less than 40 kg/m2 (less than morbidly obese or grade III obesity)
What were the results of this study
The researchers then identified the success ratio of the same day hip replacement procedure.
The researchers found 24% (27 of 112) of patients planning to have same day release surgery were not able to be discharged the same day. Some had to stay overnight in the hospital.(1)
Is a same day hip replacement discharge something patients even want?
Here is an interesting survey from doctors who perform same day hip replacements published in the The Journal of Arthroplasty.
Survey results of patients offered same day release joint replacement:
- Very few patients expected same–day discharge or a one night stay in the hospital.
- Only 55.3% of men and 31.7% of women reported that they were comfortable with outpatient same day joint replacement
- The same group believed that the best benefit of same-day release joint replacement was faster recovery and decreased the likelihood of infection.(2)
Recovery and rehabilitation from Same Day Hip Replacement Surgery
- Very limited mobility 4 to 5 days. You will need a caregiver or family member.
- If after the surgery you can walk on crutches or with the use of a walker, you will likely have in-home physical therapy. If you cannot walk with aids, then it will be strongly suggested that you go to a nursing home to recover.
- You must be careful and not fall! During recovery some patients may “overdo it,” and their activities make them a fall risk. A fall can damage the hip replacement hardware and require further surgery.
- No driving at least 3 to 6 weeks, maybe longer
- After 6 weeks, as long as there is full hip movement, your doctor may recommend that you can return to work if it is not a physically demanding job.
- Sexual activity can be resumed at this time as well, after 6 weeks, as long as there is full hip movement.
All the while there is also physical therapy, visiting nurses, and other home help people.
Same day hip replacement? Options that keep your own hip
The purpose of our writing this article is because many people who contact our office are looking for an alternative to traditional total hip replacement. They see possibilities in Prolotherapy and stem cell therapy as a completely non-surgical option.
In the video below, a patient examination is performed and discussed to show who would be a good candidate for Prolotherapy, a non-surgical, in-office procedure.
The benefits of Prolotherapy:
- Same-day, in-office simple procedure
- Can often go back to work the same day
- Learn more in video
In the video examples of patients being treated with stem cell or bone marrow Prolotherapy. This is our alternative to hip replacement surgery.
1 Goyal N, Chen AF, Padgett SE, Tan TL, Kheir MM, Hopper RH, Hamilton WG, Hozack WJ. Otto Aufranc Award: A multicenter, randomized study of outpatient versus inpatient total hip arthroplasty. Clinical Orthopaedics and Related Research®. 2017 Feb 1;475(2):364-72. [Google Scholar]
2 Meneghini RM, Ziemba-Davis M. Patient Perceptions Regarding Outpatient Hip and Knee Arthroplasties. The Journal of arthroplasty. 2017 Sep 1;32(9):2701-5. [Google Scholar]