What is Outpatient Total Knee Replacement?
Total knee replacement is the surgical treatment for knee arthritis, where the damaged knee is resurfaced with an artificial knee implant. Traditionally performed as an inpatient procedure, total knee replacement surgery is now being conducted on an outpatient basis, allowing you to go home on the same day of the surgery.
This is made possible with recent advances such as improved regional anesthesia techniques, minimally invasive surgical techniques, multi-modal pain management protocols, and physical therapy starting early and often after surgery.
When is Outpatient Total Knee Replacement Considered?
Outpatient total knee replacement is considered in active patients without significant medical issues who are interested in going home the same day.
Outpatient Total Knee Replacement Procedure
Prior to outpatient knee replacement, we employ multi-modal pain management techniques to start getting ahead of pain prior to the patient going into the operating room. A nerve block is often used which consists of an injection in the thigh that numbs the area around the knee.
- Surgery is performed under sterile conditions in the operating room under epidural, spinal, or general anesthesia. You will be lying on your back on the operating table with a tourniquet applied to your upper thigh to reduce blood loss.
- Your surgeon will then make an incision along the affected knee to expose the knee joint. The surgeon first focuses on the femur (thighbone). The damaged portions of the femur are cut at the appropriate angles using specialized tools or robotic instruments.
- Then the femoral component is attached to the end of the femur with or without bone cement. The next step involves removal of the damaged area of the tibia (shinbone) and the cartilage. It allows for a smooth surface to which implants can be attached.
- The tibial component is then secured to the end of the bone using bone cement or screws. Your surgeon will place a plastic piece called an articular surface between these implants to ensure a smooth gliding movement.
- This plastic insert acts in a similar way as the original articular cartilage and helps in supporting your body weight as well as allows the femur bone to move over the tibia. The femur and the tibia bone with their new components are put together to form the new knee joint.
- To ensure that the patella (knee cap) glides smoothly over the new artificial knee, its rear surface is prepared to receive a plastic component. With all its new components in place, the knee joint is examined through its range of motion.
- The incision is then closed with stitches that are all buried underneath the skin and dissolve on their own over time. There are no stitches or staples that need to be removed. A waterproof antibacterial band-aid is placed over the incision and keeps it protected for 7 days.
- Patients are walking within a few hours of surgery. Patients walk several times the same day as the surgery prior to discharge home.
As there is less tissue damage around the knee during the minimally invasive surgery, you can expect a shorter hospital stay, faster recovery and a smaller surgical scar.
What to Expect after Outpatient Total Knee Replacement
Several hours after surgery, you will be discharged home from the hospital. At home, physical therapy and nursing typically come to the house for 2 weeks. Following this, patients typically attend outpatient physically therapy for approximately 6 weeks.
Advantages of Outpatient Total Knee Replacement
The advantages of the outpatient procedure include:
- Minimal surgical dissection
- Shorter recovery period
- Shorter hospital stay
- Reduced postoperative pain
- Less blood loss during surgery
- Increased range of motion after surgery
- Less damage to surrounding tissues
