Mass General Waltham Now Offering Outpatient Joint Surgery

Mass General's Department of Orthopaedic Surgery offers specialized treatment for all varieties of joint pain, stiffness and immobility. Total joint arthroplasty (TJA) is one such treatment—a surgical procedure that restores joint function in patients with arthritis of the hip, knee, shoulder or ankle. TJA is typically recommended only once non-surgical options have shown to be ineffective in relieving a patient's chronic pain and mobility issues. Because the surgical and implant technology for joint replacement has advanced significantly in recent years, the procedure can now be performed in an outpatient setting in certain circumstances, that is, as "day surgery." For otherwise healthy, active patients with a support network at home to aid in recovery, joints can be repaired or replaced with speed and precision in Mass General Waltham's convenient outpatient surgery center. This enables our patients to recover in the comfort of their own home the same day they have their surgery, with no costly overnight hospital stay.

With 10 state-of-the-art operating rooms, advanced imaging facilities and free parking, Mass General Waltham offers patients access to Harvard-affiliated orthopedic surgeons from the #1 research hospital in the nation in a convenient suburban outpatient setting. Mass General Waltham is the flagship home of Mass General's Foot and Ankle service, offering patients with foot and ankle arthritis a "one-stop shop" for foot care.

In addition to comfortable waiting areas, inviting doctor's offices and pristine surgical suites, Mass General Waltham has the onsite imaging capabilities needed for arthroscopic surgery. Ankle patients, for example, undergo the weight-bearing CT scans that are required prior to Total Ankle Arthroplasty (TAA) at our Waltham locations, and an onsite foot and ankle retail store conveniently sells braces, footwear and other necessary items to aid recovery and mobility. For more information and to schedule an appointment with one of our outpatient surgeons, call Mass General Waltham at 781-487-4024 and select option 1 for ankle surgery, option 3 for shoulder surgery or option 8 for hip or knee surgery.

Total Hip Arthroplasty in Waltham

Because of advances in surgical technique, implant technology and pain management, outpatient or "same-day" hip replacement is an option for some patients with arthritis and other hip conditions that do not respond to more conservative treatment plans. Outpatient total hip replacement, or Total Hip Arthroplasty (THA), involves replacing the damaged joint with an implant through a small incision, and is safe and fast enough that you can be released afterwards to recuperate at home. If your doctor has recommended hip arthroplasty to you, and you are interested in learning if you qualify for undergoing the surgery in an outpatient setting, make an appointment to be evaluated by our outpatient surgical team. Call Mass General Waltham at 781-487-4024 and select option 8 for the Hip & Knee Service, then select either option 1 for an appointment with Christopher Melnic, MD or option 2 for an appointment with Hany Bedair, MD.

Outpatient Hip Arthroplasty: What to Expect

Once you schedule your outpatient hip surgery at Mass General Waltham, you may wonder what the day of the surgery will be like, and how long it will take you to recover and get back to the things you love to do. Your surgical team will give you clear instructions on how to prepare for your surgery, including fasting guidelines, what to wear to the surgical center and when and how your family and friends can help. Your anesthesiologist will give you a spinal anesthetic for the procedure, and you will be sedated while it is performed. Your surgeon will operate using minimally invasive techniques. You can expect mild to moderate pain and numbness following surgery, and a member of our team will be with you in the recovery suite to address any needs you have and help manage pain immediately.

You will be given detailed instructions on how to get in and out of the car and how to navigate your home, including how to use the bed, bathroom and any stairs while you heal. Any necessary medications will be prescribed, and follow-up appointment(s) with your surgeon, a physical therapist and a home health aide (virtual and/or in-person) can also be scheduled at your convenience.

Total Knee Arthroplasty in Waltham

Because of the weight we place on our knees when we walk, many people assume knee surgery needs to be performed in an inpatient hospital setting. Decades ago, this was true: most knee surgeries, including knee replacement, would mean staying in the hospital for up to ten days. Nowadays, because of advancements in surgical procedures and optimization techniques, a portion of otherwise-healthy patients needing partial or total knee replacement can have the procedure done as day surgery. Specialists from Mass General's Center for Hip & Knee Replacement can meet with you to carefully review the condition of your knee(s) and discuss your candidacy for outpatient surgery. Call Mass General Waltham at 781-487-4024 and select option 8 for the Hip & Knee Service, then select either option 1 for an appointment with Christopher Melnic, MD or option 2 for an appointment with Hany Bedair, MD.

Outpatient Knee Arthroplasty: What to Expect

You will be sedated for your knee surgery, with an anesthesiologist administering spinal and local anesthetics. The incision will be on the front of your affected knee, and is typically about six inches long. Post-surgical pain will be minimal to moderate, and we will address your pain with you and discuss relief medications and techniques immediately following surgery. Once you are released from the surgery center, we advise patients to rest in bed as soon as they get home. You can typically resume showering and other normal activities the day after surgery, and your visiting nurse and physical therapist will discuss the details of your individualized recovery plan with you once you have gotten a full night's sleep.

Total Shoulder Arthroplasty in Waltham

After exploring non-surgical treatment options with Mass General's shoulder team, patients with arthritis may consider total shoulder arthroplasty (TSA), i.e., shoulder replacement. Providers may suggest this procedure to patients if they have significant cartilage damage or loss due to wear-and-tear or shoulder trauma, or significant rotator cuff tears not amenable to repair or reconstruction. Rather than removing and replacing the entire shoulder joint, TSA is a process whereby the joint is resurfaced in places the cartilage has been worn away, in order to reduce friction, alleviate pain and ease joint movement.

Your doctor will consider your medical history and overall health when determining if TSA in an outpatient setting like Mass General Waltham is a viable choice for you. They will discuss all available treatment options with you and, together, you will decide your treatment plan. Age is not necessarily a limiting factor, and well-managed medical problems, such as hypertension or diabetes, also may not disqualify a patient for the procedure. Call Mass General Waltham at 781-487-4024 and select option 3 for the Shoulder Service.

Outpatient Shoulder Arthroplasty: What to Expect

The TSA surgical procedure typically takes around two hours. After waking up in the recovery room, patients are sent home to continue to rest. Your doctor will discuss a post-surgical physical therapy plan with you and prescribe appropriate pain medication with you following surgery. Recovery time varies, but most patients experience shoulder pain relief within days of the operation, often returning to daily life within a week. Surgical site discomfort can last a few weeks, with a gradual decrease in pain each day. A sling is used for two to four weeks to protect the shoulder. While overall functional improvement occurs throughout the first year of recovery, about 80% of improvement occurs in the first six months following surgery. Most patients report they can sleep well within one month of surgery.

Total Ankle Arthroplasty in Waltham

Like TSA, TAA, also known as ankle replacement surgery, is rapidly evolving as a type of joint replacement that can be performed in an outpatient setting. TAA is a surgical option for otherwise relatively healthy patients who suffer from debilitating ankle arthritis as a result of trauma, gout, inflammatory arthritidities or other conditions that over time have served to impair ankle joint integrity and function. TAA can potentially remedy the chronically painful ankle when traditional non-surgical treatments have proven ineffective. Compared to other surgical solutions for end-stage ankle arthritis, such as ankle fusion, TAA allows for preservation of range-of-motion while also being a significant pain reliever in most cases. If your doctor has recommended you undergo ankle replacement, an outpatient setting provides a relaxed, comfortable and convenient patient experience. The experts in Mass General's Foot & Ankle Service can evaluate your ankle arthritis and help you decide whether outpatient ankle surgery is the best option for your unique situation. Call Mass General Waltham at 781-487-4024 and select option 1 for the Foot & Ankle Surgical Service.

Outpatient Ankle Arthroplasty: What to Expect

Ankle replacement surgery typically takes one to three hours, and patients are sent home on the same day to begin their recovery. Patients are instructed to stay off the operated ankle for the first two to three weeks, until the surgical sutures come out, at which time they begin a rapidly progressive weight bearing and physical therapy program and rehabilitative protocol that their doctor will provide. During this period, patients transition from a post-operative splint into a special boot to protect the area during early recovery, and they will generally meet with members of the surgical team for postoperative check-ups over the first four months. Patients who heal routinely will be weaned from boot to sneaker by the fourth month of recovery, and activity will be ramped up accordingly. The anticipated overall recovery process from this procedure generally takes about a year from the date of surgery, although patients are gradually reintegrated into certain activities over the course of the final eight-to-nine months of this healing process, commensurate with their overall health, functional expectations and ankle joint tolerance.

FAQs: Total Joint Replacement in an Outpatient Setting