Outpatient Joint Replacement

Dr. Pritchett frequently performs hip resurfacing as well as hip, knee, and shoulder replacements in an outpatient ambulatory surgical center. When patients have outpatient joint replacements, they are able to return home the same day (usually within a few hours). There are several benefits to outpatient joint replacement surgery. For this reason, approximately 95% of Dr. Pritchett’s hip, knee, and shoulder replacement procedures are done in an ambulatory surgical center. He calls this the “Fast-Forward” program and it has also been adopted by other surgeons.

Dr. Pritchett has a tremendous amount of experience in outpatient joint replacement surgery, and has done joint replacements in outpatient centers throughout the entire span of his 35-year career as a surgeon. He also gained experience and knowledge about outpatient surgery before entering into private practice. In high school, Dr. Pritchett worked for Dr. Walter Scott Brown, one of the pioneers of outpatient surgery. There, he was able to learn more about how outpatient surgery centers operate. Additionally, Dr. Pritchett’s residency was at a high-volume trauma center with a limited number of beds, which often meant that elective procedures including joint replacements went home the same day to keep beds open for trauma patients. All of this helped Dr. Pritchett build his experience in providing safe and efficient care for his patients.

Benefits Outpatient Joint Replacement

There are several benefits to having your hip, knee, or shoulder resurfacing or replacement as an outpatient, including the following:

• Recovering in comfort as an outpatient. Patients often feel more comfortable in their own homes or hotel room than they do in the hospital. They know the layout, and therefore are usually more comfortable getting up and moving around when needed.
• Lower risk of blood clots. Patients who go home the day of surgery are often moving around sooner and more frequently. This greatly reduces the risk of blood clots.
• Lower infection rate. Though hospitals do everything they can to reduce infections, hospitals also host sick people, so there is a higher risk of getting an infection in a hospital. In your own home, you will come into contact with fewer people and have control over who comes in and out, which reduces your risk.
• Potential cost savings. For some patients, outpatient surgery may be a more costeffective option, particularly if it is a cash pay or not a fully covered by the patient’s health insurance.

How Outpatient Joint Replacement Differs from Inpatient Joint Replacement

Dr. Pritchett performs the following procedures in ambulatory surgical centers:

• Total Hip Replacement
• Total Knee Replacement
• Total Shoulder Replacement
• Hip Resurfacing
• Partial Knee Replacement
• Shoulder Resurfacing

The procedure and discharge criteria are the same whether the patient stays in the hospital or not. However, patients undergoing outpatient joint replacement only receive a short-term anesthetic timed for the length of the procedure; they do not receive intraoperative narcotics. They receive pre-emptive multimodal medications and long acting local anesthetic medication is injected into the tissues around the joint during the surgery. Patients receive a medication to reduce blood loss. Drains and transfusions are never necessary.

All this means that outpatient procedures need to be more efficient. Dr. Pritchett’s practice has invested in an infrastructure that allows his team to take excellent care of patients. All the necessary and high tech equipment necessary are available at Dr. Pritchett’s office and the ambulatory centers he uses. This, combined with his many years of experience, ensures that each procedure is both efficient and effective.

Patients who have had surgery in an ambulatory setting also meet with a post anesthesia nurse immediately and if a physical therapist is needed they meet the therapists an average of two hours sooner than patients who stay in a hospital. Even better, the nurse or physical therapists go directly to the patient in the ambulatory surgical center, so patients aren’t having to move from room to room after surgery.

Medication management is also much more focused with outpatient joint replacements to ensure that the patient can recover comfortably. About 50% of patients do not take any narcotics after outpatient joint replacement. Dr. Pritchett’s team also focuses on pre-hydrating patients in the ambulatory surgical center so that they do not dehydrate upon returning home.

Preparing for Outpatient Joint Replacement

Dr. Pritchett takes special care to ensure that patients are well-prepared for their procedure. More importantly, he places special emphasis on making sure the patient’s caregiver is properly selected and prepared. In addition to providing excellent educational materials to patients, Dr. Pritchett also personally meets with the patient’s selected caregiver to ensure they are up to the task of helping the patient at home. The patient’s caregiver will be critical to their success in recovering at home, as that person will have to take care of many of the patient’s needs. A good caregiver will help the patient remain calm and contact Dr. Pritchett if there is a problem. If Dr. Pritchett does not feel the caregiver or setting is right for the patient, he will not move forward with outpatient joint replacement.

Patients are instructed in the correct activity and exercise after surgery in a pre-habilitation process. Their surgical procedures are planned in advance with the type, size and position of the implants planned in advance from digital imaging.

Dr. Pritchett understands that some patients have anxiety about recovering outside of a hospital. Some patients are worried that they won’t get medical attention quickly enough if they are at home. However, our data with more than 3000 procedures over several years shows an excellent and, in fact, better continuum of care with outpatient surgery compared to inpatient. Patients interact with Dr. Pritchett and his staff throughout the entire surgery and recovery process. Dr. Pritchett and his staff deal with a lower volume of patients at a single time than onduty nurses at hospitals, so their response times are usually quicker than what patients experience at a hospital. Dr. Pritchett also gives patients his personal call phone number or cell phone number so that they can contact him at any time with questions or problems 24/7. Patients are provided with detailed instructions and a description of the common types of concerns patients have following surgery. All of these measures ensure that patients are well taken care of during outpatient joint replacements.

Another common concern patients and some less experienced surgeons have is that it will become necessary to change the plan during the procedure and have the patient stay at a hospital. However, because Dr. Pritchett is so experienced with outpatient surgery, he does not have to change plans during the course of the procedure. He spends enough time getting to know the patient and the patient’s caregiver that he is able to accurately determine before surgery whether or not a patient can return home or to their hotel.

Outpatient Joint Replacement in Seattle, WA

Dr. Pritchett has 35 years of experience with outpatient joint replacements and has performed joint replacements in ambulatory surgical centers throughout his entire career. The vast majority of resurfacing as well as hip, knee, and shoulder replacement cases are suitable for outpatient surgery with Dr. Pritchett. If you have any questions about outpatient joint replacement or would like to schedule a consultation with Dr. Pritchett, please call our office at (206) 323-1900.