Conditions & Treatments

Outpatient Joint Replacement

Minimally invasive same-day knee, hip and shoulder joint replacement is a reality today. The expert surgeons at South County Orthopedic Specialists (SCOS) in Orange County have specialized training in minimally invasive joint replacement surgery. Additionally, each staff member is specially trained in joint replacement surgery and the needs of patients who choose outpatient joint replacement. At SCOS we apply an integrated, coordinated approach to patient care because we want to achieve the best outcome for our patients.

Patient selection for outpatient joint replacement is critical to it’s success. Candidates are patients who are healthy enough for outpatient surgery.  These candidates must have appropriate home support, a healthy BMI, appropriate medical history, personal motivation and family support.

Preoperative patient education is necessary to prepare the patient for outpatient surgery.  Patients will also receive detailed post-operative instructions, and are setup with early home and/or outpatient therapy.

SCOS offers full-service comprehensive orthopedic care for patients in Laguna Woods, Irvine, Orange County and surrounding areas. We have dedicated surgeons who have been serving the area with compassionate, expert care since 1974. We are affiliated with Saddleback Memorial, Hoag Orthopedic Institute, Mission Regional Medical Center, Memorial Care Surgical Center and Specialty Surgical Center of Irvine, for ambulatory surgery.

Traditionally, joint replacement surgery is performed in a hospital. Outpatient joint replacement is possible due to recent advances in surgical technique, implant technology, anesthesia and pain control. Very few, if any, patients require skilled nursing, rehab or home health care following outpatient joint replacement surgery.  Outcomes are the same as with inpatient joint replacement. But, new and improved clinical protocols make it possible to release patients more quickly.

Specifically, advances in perioperative anesthesia, minimally invasive techniques, implant technology and initiation of rehabilitation soon after surgery have made outpatient joint replacement a reality. Moreover, patient education empowers patients, which improves the quality of care, and safety.

Patients can expect to sit within two hours after surgery, and walk with a cane or walker 5-6 hours after surgery.  A patient must be able to get in and out of bed on his or her own and climb stairs in order to be discharged. Rehabilitation begins soon after surgery.

Advantages of outpatient surgery include:

  • None or very limited hospital stay (23 hour stay) overnight – the choice of surgical setting is based on each patient’s medical condition and whether an overnight stay is needed.
  • No costly overnight hospital stays.
  • Rapid recovery due to improved pain management.
  • Less blood loss during surgery which reduces the need for a transfusion and facilitates improved long term outcomes.
  • Better outcomes occur when patients are up faster than waiting a few days in the hospital before moving.
  • Minimally invasive surgical techniques minimize trauma which decreases post op pain, and the need for extensive rehab, and offers a rapid return of strength.
  • Minimally invasive surgery also decreases operating time to about 1-2 hours.
  • A rapid rehab pathway is started almost immediately after surgery.
  • Faster ambulation and beginning therapy within hours of surgery reduces pain.
  • Reduced risk of hospital acquired infections.
  • Reduced risk of post op complications.
  • Increased convenience and satisfaction.
  • Lower cost.

Candidates for outpatient surgery are healthy patients with no risk factors, who are willing and able to return home with home support, and seek to maintain an active lifestyle. Even elderly patients who are healthy are potential candidates. For those who are obese or suffer unstable health conditions, outpatient joint replacement may not be recommended.

Pre and Post Patient Preparation

Your surgeon at SCOS will provide patients seeking outpatient joint replacement with complete educational information, including preoperative information to establish patient expectations, and full after care instructions will also be provided.

You will learn:

  • How to prepare your home
  • What to bring to the surgery center
  • The equipment you will need
  • What to expect during surgery and after
  • Exercises to prepare for surgery
  • Pre and post operation diet discussion

Pain control

Multimodal pain management includes pain management in the operating room and pain medication for home, as well as medication to reduce nausea and vomiting.

How to live with your new joint

It is important to take care of your new knee or hip. Your new joints are designed for the daily activities of life and lower-impact sports. Therapeutic exercise includes swimming, walking and cycling. Aggressive sports may impair or compromise joint function and long term success. We recommend you discuss specific activity related concerns with your surgeon.


Any surgery requires you to take antibiotics before and after including dental work and routine cleanings for the rest of your life.

If your knee pain or hip pain and stiffness is so painful that you have difficulty walking or climbing stairs, and you have pain while seated or lying down, a total knee replacement or total hip replacement may be the appropriate solution to allow you to return to your normal daily activities.  Call SCOS in Orange County, California to learn about outpatient knee and hip joint replacement.  Dr. Lance Montgomery and Dr. Larry Gersten are hip and knee replacement experts who specialize in outpatient, minimally invasive joint replacement.

If your shoulder pain and stiffness is limiting you from either daily activities or those activities you once loved, Dr. Ari Youderian at SCOS Orthopedic Specialists is a shoulder replacement specialist who routinely performs outpatient shoulder replacement in Orange County, California.

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