Not long ago, a hip or knee replacement meant three or four nights in the hospital. Today, thanks to better anesthesia, gentler surgical techniques, and improved pain control, most healthy patients can safely go home the same day as their joint replacement. In fact, Dr. MacNeille discharges most of his surgery-center patients home within hours of surgery.
This is the first question most patients ask — and it has been studied carefully.
A landmark randomized trial, published in Clinical Orthopaedics and Related Research in 2017 by Goyal and colleagues (winner of the Otto Aufranc Award), randomly assigned more than 200 hip replacement patients to either same-day discharge or an overnight hospital stay. The outpatient group did just as well, with no significant difference in complications or hospital readmissions.
A 2018 systematic review in the Journal of Arthroplasty by Hoffmann and colleagues pooled the available research on outpatient hip and knee replacement and found that, in appropriately selected patients, complication rates were similar to or lower than traditional inpatient surgery.
For hip replacement specifically, a 2021 systematic review in Hip International by Shapira, Domb, and colleagues concluded that outpatient hip replacement is safe in well-selected patients, with high patient satisfaction and low readmission rates.
Same-day joint replacement works best for patients who are in reasonably good health, are motivated, and have support at home for the first days after surgery. Factors Dr. MacNeille considers include:
Patients with significant medical conditions may be safer with an overnight stay — and that is always an option when needed.
Dr. MacNeille's protocol combines several elements: muscle-sparing surgical techniques (such as the direct superior approach for hips), Mako robotic assistance, modern regional anesthesia and multimodal pain control that limits narcotics, and physical therapy that begins the same day. Patients walk, climb a test stair if needed, and go home once they are safe and comfortable.
For the right patient, same-day joint replacement is not a shortcut — it is a well-studied pathway supported by randomized trial data and systematic reviews. At your visit, Dr. MacNeille will help you decide whether it is the right fit for you.
This article is for general education and is not a substitute for medical advice.
Recovery videos courtesy of Dr. Lige Kaplan — Dr. MacNeille’s fellowship director and mentor — whose patients underwent the same minimally invasive techniques Dr. MacNeille uses today. Robotics videos from Stryker and partner hospitals. We will be adding videos of our own patients over time. Browse the full video library →
Ready to talk about your hip or knee? Request an appointment and our team will contact you within 1–2 business days.
