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What is Outpatient Anterior Hip Replacement?

With improved technology and advances in anesthesia and pain control, hip replacement surgery has evolved and is now being offered in an outpatient setting. Outpatient anterior approach hip replacement refers to surgery accessed from in front of the hip in an outpatient setting. It is a minimally invasive procedure that has been developed to cause less muscle damage, faster recovery, and less disruption in a patient’s life.

This outpatient (same-day) procedure aims at replacing a damaged hip joint affected by arthritis with an artificial implant (prosthesis) made of metal, plastic, and ceramic.

Who is a Candidate for Outpatient Anterior Hip Replacement?

Outpatient hip replacement is considered for healthy patients with minimal pre-existing medical issues. The procedure is performed at Palm Beach Surgical Suites, an outpatient surgical center, and patients are discharged to home the same day. It is important to have a family member or other individual stay with you during your early recovery.

Not all patients are candidates for outpatient surgery. The criteria required to qualify for an outpatient anterior hip replacement, include:

  • Being fit and in general good health
  • Motivated with a positive frame of mind
  • Maintains a normal weight with less muscle mass and fat in the thigh area
  • Hip condition that has failed conservative management
  • A good network of family and friends who can provide care during recovery
  • Commitment and preparedness to strictly adhere to doctor’s post-surgery instructions
  • Mobile, active, and independent prior to surgery

Procedure for Outpatient Anterior Approach Hip Replacement

The operation is performed in an outpatient setting under sedation with spinal anesthesia. The surgery will be performed on a special operating table for the anterior approach (Hana table) in combination with intra-operative x-ray. In general, your surgeon will:

  • Clean the surgical site thoroughly and mark the site for incision.
  • Make a surgical cut in front of the hip joint (anterior approach).
  • Carefully separate the muscles and tendons to view the hip joint.
  • Remove the upper part of the femur and the damaged cartilage and bone from the pelvis.
  • Replace the damaged acetabulum and parts of the shaft of the femur with an artificial joint.
  • Close the incisions with sutures and glue and apply a dressing to complete the operation.

Postoperative Care and Instructions after Outpatient Joint Replacement

After surgery, you will spend the next several hours in the recovery room where you be monitored for vital signs, pain control, and the ability to eat and take pain medicine by mouth. The nursing staff will ensure that you can walk safely with a walker as well as use the restroom. An x-ray will be performed prior to your departure. Once you’re home, a home health nurse and physical therapist will come to your house to start your rehab program.

You will be given a pain control protocol to ease pain. Compression stockings are recommended to prevent blood pooling in your legs. Patients are encouraged to wear compression shorts to reduce swelling around the hip area. 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 walker followed by a cane
  • Suture and dressing care
  • Physical therapy and exercise regimen to improve walking, range of motion and strengthen muscles
  • Shower instructions
  • Adherence to prescribed medications
  • Adherence to follow-up appointments

Benefits of Outpatient Surgery

As it is an outpatient surgery, you will be discharged home the same day after your anesthesia wears off. Recovering from home means leaving the hospital setting and getting to recuperate in the comfort of your own 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 outpatient surgery include:

  • Less pain: Outpatient surgery does not involve a pain pump for self-administered medications or IV pain medicines.
  • Fewer transfusions: Patients are less likely to require blood transfusions due to improved surgical techniques involved with outpatient surgery.
  • Convenience: The convenience of recovering in your home generally makes recovery time easier than in an inpatient setting.
  • Lower cost: Since there are no hospital room charges and related hospital charges, costs are much lower with recovery at home.
  • Better recovery: You feel isolated in a hospital setting due to lack of social interaction that negatively affects your recovery. You will recover better in a home setting with care and interaction from your family and friends.
  • Safer: Home recovery is much safer compared to a hospital stay as you are at risk of developing a hospital-acquired infection (HAI) in a hospital setting, no matter how sterile a hospital environment is.

Risks and Possible Complications of Outpatient Anterior Approach Hip Replacement

Outpatient anterior approach hip replacement is a relatively safe procedure; however, as with any surgery, it does carry some risks, such as:

  • Blood clots
  • Infection
  • Bleeding
  • Injury to nerves and blood vessels
  • Leg length discrepancy
  • Hip joint dislocation
  • Joint loosening