What is it and why do It?

  • Outpatient joint replacement means that we do your joint replacement procedure in our outpatient ambulatory care facility or, if your insurance plan does not allow that (most commonly if your insurance is Medicare) we do your procedure in the hospital but send you home the next morning.
  • Most people are much happier and more comfortable recovering from their joint replacement procedure in their home rather than in the hospital.
  • The chances of a hospital or rehab facility acquired infection are greatly reduced.

How is it done?

Home Assessment and home care after your procedure

  • Your home environment is assessed before surgery to make sure it is safe and appropriate.
  • Outpatient nurses and physical therapists come directly to your home until you are completely mobile and can go out safely for therapy and postoperative visits with Dr. Tauro.

Pain control is VERY important to us!

  • We use a combination of spinal anesthesia (for hips and knees), regional nerve blocks and local injection of pain and anti-inflammatory medication to dramatically reduce postoperative pain.
  • For knee and shoulder replacements, we use a tiny tube that numbs most of the surgical area for up to three days.
  • Our anesthesia and pain management team is available to help you with any pain related problems after your surgery.

Surgical technique – Knee Replacement

  • We exclusively use techniques that do not cut any muscle so that you can walk immediately.
  • For total knee replacement that means we go under the quadriceps muscle rather than through it (the “sub vastus approach”).
  • The traditional approach through the quadriceps tendon or through the quadriceps muscle is shown below:knee-replacement-traditional-approach
  • The sub vastus approach, shown below, goes under, rather than through the muscle. We use this approach in the vast majority of our knee replacements, even complex revision cases:knee-replacement-sub-vastus-approach

Surgical Technique – Hip Replacement

  • For total hip replacement we use an anterior approach which goes between the muscles of your hip rather than through them. No pillow between the legs is needed and motion precautions after surgery are much less.
  • The anterior approach, shown below, goes between and not through the front muscles of the hip:hip-replacement-anterior-approach
  • Shown below is the traditional posterior approach to the hip which requires splitting the buttocks muscle (The gluteus maximus) and then detaching the short external rotator muscles to get to the hip joint.hip-replacement-posterior-approach

Surgical Technique – Shoulder Replacement

  • Shoulder replacement has been an out patient procedure for us long before hips and knees and is ideally suited for it
  • Although all types of shoulder replacements require a small amount of muscle detachment, we keep it to the minimum possible with special tools and smaller implants
  • We use the latest anatomically correct implants and biologic fixation to maximize both early results and durability of the replacement
  • In some patients, we can perform a resurfacing procedure which preserves more of the normal bone around the shoulder