Beast of burden? Understanding the impact of outpatient total hip and knee replacement on caregivers at home

Excerpt

Recent advances in surgical technique, preoperative assessment, patient preparation, anesthesia, and analgesia have all contributed to the ability to perform same-day total hip arthroplasty (THA) and total knee arthroplasty (TKA) in select patients.¹ Traditionally, patients undergoing THA or TKA would have stayed in hospital for nearly five days after surgery for pain management and rehabilitation. These patients occupied valuable hospital beds that could be used by other services and cost the healthcare system tens of thousands of dollars per hospital stay.² The introduction of targeted motor-sparing nerve blocks, novel perineural adjuncts, and local anesthetic infiltration techniques, all combined with preventative and therapeutic perioperative multimodal analgesia and management of related side effects, has led to reductions in the length of stay such that an ever-increasing cohort of patients is being discharged from the hospital on the same day as surgery.³ The current COVID-19 pandemic has further accelerated interest in shorter-stay total joint arthroplasty (TJA) surgery to relieve the strain on our healthcare system and the significant surgical backlog.⁴ …