Outpatient Joint Replacement: Practical Guidelines for Your Program Based on Evidence, Success, and Failures

Joint arthroplasty is increasingly being performed in ambulatory surgery centers (ASCs). Enabled by enhanced recovery protocols and multimodal pain management, and incentivized by the implementation of value-based payment models, this trend is projected to continue, with more than half of total joint replacements predicted to be outpatient by 2026.¹ Like any advance in healthcare, this transition offers both new advantages and new challenges. ASCs provide opportunities to improve patient satisfaction and outcomes while lowering costs, but realizing these advantages requires a new level of presurgery preparation for both surgeons and patients. This chapter outlines key considerations for success when transitioning to performing joint arthroplasty at ASCs. Paramount among these are patient selection and preparation. Additional considerations include protocol optimization through data tracking and iterative refinement. A clear understanding of the differences in performing joints at an ASC versus a hospital outpatient setting enables surgeons to make the transition smoothly, maintain a high-quality patient experience, and deliver optimum outcomes.