Orthopedic surgeon here. Outpatient total joint replacements have taken off like a rocket in the last few years, in part due to advances in due to pain control (pre operative peripheral nerve blocks, etc), accelerated physical therapy, and all around better management and prevention of all the common postop complaints (nausea, opioid induced constipation, etc), but I would say the number one driver has been that insurance companies (including Medicare) will finally pay for it to be done outpatient. 3 years ago you had to keep people in the hospital at least overnight to even get reimbursed. The same phenomenon has happened with many of the spine procedures that can now be done outpatient. The actual surgical techniques have not really changed much over the last few decades other than popularizing a few approaches (anterior vs posterior) or bearing surfaces (metal on polyethylene vs ceramic on polyethylene, etc).
ubermonkey|3 years ago
I was under by 7am, and aware of enough to look at the clock on the wall in the recovery area by 1030 or so. Time is weird for a bit, but by 1230 I was in a room still a little dazed, but eating.
At that point it was a checklist party. I had to see several specialty providers -- PT, OT, respiratory person for the incentive spirometer lesson -- plus eat, drink, walk and pee. As I had been a very compliant patient the night before, and had peed BEFORE the procedure, it was the last one that took the longest despite drinking a ton of water.
It seemed clear there were several "offramps" that I could've needed that would have resulted in an overnight stay, like the postoperative nausea you mention, but I was fine.