As healthcare is ever changing we are seeing a trend towards outpatient procedures. Outpatient joint replacement surgery is a safe option that reduce the time you need to spend in the surgical center. In the past outpatient joint surgeries have been performed in a hospital setting, but the national trend has been towards ambulatory surgery centers like the practice of Dr. John Moore. If you are interested in an outpatient joint replacement, contact our Pinehurst, NC office today.
How is Outpatient Joint Replacement Surgery Different From Normal Joint Replacement?
Outpatient joint replacement surgery is nationally trending as the first choice for many qualified patients. Studies have shown that outpatient joint surgery has numerous benefits for the patients over traditional joint replacements. These include:
- Faster recovery
- Improved outcomes
- Decrease in infection rates
- Increased patient satisfaction scores
- Lower complication rates
Candidates for Outpatient Joint Replacement in Pinehurst, NC
Candidates for outpatient joint replacement surgery are restricted to physically healthy, medically managed and socially supported patients.
Dr Moore has successfully performed over 500 Robotic assisted total knee replacements including surgeries done at Moore Regional Hospital and Surgery Center of Pinehurst. Dr Moore performed his first robotics assisted surgery at Surgery Center of Pinehurst in 2020 and is by far the most experienced Fellowship trained orthopedic surgeon in North Carolina.
Dr Moore is the founding surgeon pioneering the OUTPATIENT total joint replacement surgery program at Surgery Center of Pinehurst with his first outpatient surgery completed in 2009. Dr Moore has completed over 700 same day discharge joint replacements at Surgery Center of Pinehurst since 2009 and counting.
What Happens if I Don’t Get Joint Replacement?
Joint replacement surgery is highly successful:. After Joint replacement, patient most often report has given them their lives back. Joint diseases like osteoarthritis, avascular necrosis and rheumatoid arthritis pain causes patients to loose their mobility and function, thus decreasing their ability to participate in the activities and family functions they love. A damaged, painful joint can be treated short term with medications, injections and physical therapy. Patients with end-stage, bone-on-bone disease will only have long standing pain relief and return of function with total joint replacement surgery.
These are completely personal choices, but these are some signs that it could be time to have Dr. Moore perform joint replacement:
- You can no longer do many routine tasks without help.
- You have significant pain that keeps you awake, keeps you from being able to walk or bend over, pain that doesn’t go away with non-surgical treatment or rest.
- You’ve tried non-surgical options, such as physical therapy, and the pain is the same.
- You have osteoarthritis and joint degeneration is the cause of your pain.
- Pain is affecting you mentally and emotionally.
- Tests such as imaging scans detail extensive joint damage that cannot be repaired.
Where Are Outpatient Joint Replacements Performed?
How is an Outpatient Surgical Center Better Than a Hospital?
The outpatient joint replacement procedure is the same as a hospital setting. The key difference is in the concierge experience. Patients of Dr. Moore will stay one night at our outpatient surgical center, The Surgery Center of Pinehurst. While there, two highly qualified and dedicated nurses (2:1 nursing ratio) will be by your side for any needs or concerns.
Does Outpatient Joint Replacement Cost More Than Inpatient Joint Replacement?
Under the North Carolina State Health Plan with Aetna, state employees and teachers will only pay an out-of-pocket expense of $600 for their outpatient total joint replacement at Pinehurst Surgical. If a patient were to receive inpatient treatment for their total joint replacement, their deductible is expected to be significantly more. While outpatient treatment allows patients to achieve a successful recovery in their homes, it will also help patients and their families save money.
Even if a patient is not local to Pinehurst, NC, any North Carolina resident under the State Health Plan would save money if they traveled to Pinehurst Surgical for outpatient treatment and then returned to their local cities for recovery. Because we send physical therapists directly to your home to help with your recovery after surgery, this travel investment often costs patients much less money than a several-day inpatient hospital stay.
Pinehurst Surgical Clinic in cooperation with Surgery Center of Pinehurst also offers Payment bundling programs thru other insurance companies such as Optum, Commercial BCBS PPO, Aetna, self pay bundle program, and Medcost.
Most all other insurance companies (including Medicare and Medicare replacements) cover outpatient joint replacement with same day discharge as well. Should you determine outpatient total joint replacement is your preference our surgery scheduling team can help in determining the finances associated with choosing a surgical site.
Should I Start or Stop Any Medications Prior to Surgery?
One of my advance practice professions (Michelle Moore or Steve Balos) will discuss any medications you are taking with you during your consultation. We will want to see the actual bottles of your medications, both prescription and over the counter. That way we can ensure the accuracy of your dosages and dosing requirements, and we will know which medications will need to be stopped or delayed.
There are some standard medications you will need to stop taking prior to your surgery. These are blood thinners, anti-inflammatory medications, weight loss medications/some diabetes medications, aspirin, and most herbal supplements. All of these can lead to increased bleeding.
While not a medication, if you smoke cigarettes, you will also need to stop smoking for at least two weeks prior to your procedure and two weeks following. This is because smoking constricts the blood vessels, and this impedes the healing process.
What Will I Need to Do to Prepare for My Procedure?
We will walk you through preparation such as food restrictions prior to your surgery and the other details. But you also should prepare your home for your return home after your joint replacement.
You can think of it as prehabilitation, getting ready for your recovery in your home. After all, when it gets right down to it, most of us would rather be laid up in the comfort of our own home than in an austere hospital setting, but it can scare some potential same-day patients that they won’t receive the same “hand holding” at home as they would in the hospital.
But if you’ve prepared your home and your mind for recovering at home, you’ll be amazed and how much easier your recovery can be. Patients who do their “PreHab” love outpatient joint replacement with Dr. Moore and their ability to recover in their own bed surrounded by their own stuff.
We’ll give you a list of all you’ll need to do to get your home recovery space ready. It’s not difficult.
How Much Pain is Involved After Joint Replacement Surgery?
Knee replacement involves more post-operative pain than hip replacement for most patients. Your pain will have changed from the aching arthritic pain before surgery to wound healing, swelling, and inflammation-related pain. Dr. Moore’s patients often report little or no pain just 2-6 weeks after their hip replacement. For knees the timeframe is longer, with little or no pain around the three-month mark.
People wonder why knee replacements involve more pain. This is likely because the knee joint is a more confined joint than the hip, so swelling increases stiffness and pain. Plus, more bone and cartilage are usually involved with knee replacement versus hip replacement. Plus, the knee takes more effort to regain range of motion, hence the slower rehabilitation of the joint compared to the hip.
The Joint Replacement Procedure
Prior to your procedure an anesthesiologist will sedate you and most patients will have a spinal anesthetic (knee replacement patients also get an adductor block for pain). This type of anesthetic causes numbness from the site of the anesthetic in your spine to your toes. It is highly unlikely that you will require a general anesthetic but should that be necessary our anesthesiologist and nurse anesthetist will be prepared to proceed if needed.
From here, your surgery with Dr. Moore will differ depending on what surgery you are receiving. To learn more about a specific surgery, please look at the following pages:
Surgery typically requires approximately one hour of time. You will be in the recovery room for one to three hours until the effect of the spinal anesthesia is worn off. Once that occurs and your vital signs are stable, you will be taken to your surgery center hospital room.
Will I Need Physical Therapy After Joint Replacement Surgery?
Yes, you will still need physical therapy after an outpatient joint replacement. Your therapy will be tailored to the type of operation that you received.
Only a few hours after surgery, the nurses will have you up walking and you will receive formal physical therapy the morning after surgery. Prior to your discharge home from the Surgery Center of Pinehurst, our physical therapists will have you walking and stair climbing. initially, be using a walker but you can advance to the use of crutches if you can master the technique. It is your personal preference whether you go home on a walker or on crutches. The physical therapist will also be certain that you understand your discharge exercise program and have all the assistive devices that will help you cope in the immediate postoperative period.
"He is easy to talk to, he listens and he is a good doctor. I trust him and his team and I would go back and I tell all my family and friends about him"
How Long Does It Take to Recover From Joint Replacement Surgery?
You should make arrangements to have intermittent help at home (spouse/ family member/friends) for the first 5-7 days after your outpatient joint replacement surgery. Although we will arrange for home physical therapy to come to you, you might need help with meal preparation, with medications and with general activities of daily living that are made safer with an extra helping hand. You should stay on your crutches or walker for the entire first six weeks after the outpatient joint replacement unless otherwise informed. Patients are able to resume most normal actives between 10-12 weeks after surgery.
Will I Ever Need Joint Replacement Again?
Artificial hips and artificial knees have lifespans, just as any manufactured product does. The lifespan of these prosthetics continues to increase as technology advances, but if you’re having your outpatient joint replacement performed at a younger age, it’s likely you’ll need a second operation to clean the bone surfaces and refixate the implants at some point.
When artificial implants fail, it is most likely when the bond between the bone and the implant loosens over time, or a component of the implant wears down. With either kind of failure, a revision surgery is needed to replace the original implant.
Studies have shown that 90 percent of modern knee replacements still function well 10-15 years after being implanted. Numbers are slightly higher for artificial hips. But today’s replacements could last far longer since orthopedic implants are evolving at a rapid pace.
Will I Need Any Medications Post-Op?
Yes, you will need prescription pain medication. Dr. Moore will prescribe this and will discuss the aspects of your pain medication that you need to be aware of.
Patient Information
Additional Information
For More information about Outpatient Joint Replacement Surgery with Dr. Moore, contact our Pinehurst, NC office, call us at 910.295.0224, or check out our orthopaedic surgery blog.