In response to the rapid annual increase in demand for outpatient joint replacement across the nation, Duke Health Center Arringdon in Morrisville now offers same-day hip and knee replacement. Five orthopaedic surgeons at the center can each perform multiple joint replacements per day. A team of specialists works together to ensure patient and caregiver readiness prior to surgery.

“Same-day joint replacement has been a massive change to how the industry has been doing things for many years, but it is becoming the standard of care for a large percentage of patients,” says Michael P. Bolognesi, MD, chief of the Duke Adult Reconstruction Division and joint replacement surgeon. This shift is due to improved anesthesia, effective pain control and less-invasive surgical techniques, as well as advances in preoperative patient education and postoperative care management.

The success of same-day joint replacement begins with patient selection, Bolognesi explains. In addition to performing a thorough preoperative assessment, Duke surgeons also evaluate the patient’s mindset, motivation, and home environment. Patients who are in good general health, do not smoke, are motivated, and have a good support team at home are the best candidates.

Benefits of the same-day joint replacement offering in Duke’s ambulatory surgery center include a more efficient experience from arrival to discharge, a potentially quicker return to normal activities, and a more comfortable recovery at home. One of the biggest benefits for appropriate patients is that it avoids hospitalization.

The team at Duke Health Center Arringdon provides customized educational resources for patients and caregivers including:  

• A one-hour preoperative class with a dedicated coordinator
• Customized educational videos on nutrition, preparing the home and the entire perioperative experience
• An assigned nurse with a direct phone number for any questions throughout the process
• A prehabilitation visit with a physical therapist on using durable medical equipment

In addition, patients are made comfortable in a private, extended stay room for both preoperative care and recovery, where the caregiver can stay throughout the same-day surgery. “The more pre-education the patients and caregivers have, the better the patients do, and the more prepared they are to go home,” Bolognesi says.

Duke's experienced surgeons feel strongly that hip and knee replacements can be done safely in the outpatient setting. “Our goal at Duke is to increase our percentage of same-day joint replacements from the current rate of 40% to a higher rate while keeping patients safe,” he adds.