The Fast Track to RECOVERY

Joint Replacement patients can go home safely just hours after surgery.

Article from Monmouth Medical Center's "Healthy Together" Winter 2020 Publication.

Benefits of Outpatient Surgery


Studies show that outpatient joint replacement surgery is safe for the right patients, says David Chalnick, MD, Medical Director of the Joint Replacement Center at Monmouth Medical Center. In a study published in The Journal of Arthroplasty, researchers found that hospital readmissions and postsurgical complications were lower among outpatients compared to inpatients.

Best Candidates


To be eligible for the “Fast Track” program, a patient must be healthy and motivated to recover quickly, says David Chalnick, MD, Medical Director of the Joint Replacement Center at Monmouth Medical Center. Also, a patient needs a family member or friend who can accompany him or her to the hospital, attend physical therapy after surgery and help at home. Another requirement: “The home must be prepared for the patient to return to a safe environment amenable to recovery without injury,” says Dr. Chalnick.


It can be overwhelming to learn you need a knee replacement or a hip replacement. In addition to undergoing surgery, patients have traditionally been required to stay overnight at the hospital. Today, thanks to the new Fast Track Joint Replacement Surgery Program at Monmouth Medical Center (MMC), many patients are returning home to sleep in their own beds. “Fast track joint replacement is being pioneered around the country,” says Bert Parcells, MD, an orthopedic surgeon affiliated with MMC. “Patients who are healthy and recovering well don’t need to spend extra time in the hospital.”

Thanks to minimally invasive surgical techniques and “lighter” anesthesia, it’s safe to be discharged soon after surgery. Patients receive the same type of anesthesia as those who have traditional joint replacement, but “the anesthesiologists minimize the sedating effects, meaning they modify some of the medications,” says Mark Gesell, MD, an orthopedic surgeon affiliated with MMC.

Fast Track patients arrive at the hospital early in the morning, have the surgery, then head to physical therapy to ensure that they can be safely discharged. If all goes smoothly, they can go home in the afternoon. “Patients are very excited about this,” says David Chalnick, MD, Medical Director of the Joint Replacement Center at MMC and chair of the RWJBarnabas Health Total Joint Integrated Leadership Committee. “It’s a very pleasant experience.”

What to Expect


One month prior to surgery, patients can attend an in-person educational class and meet with a “graduate” of the joint replacement program. They also have the option of watching an educational video given by a nurse educator virtually. They discover a key benefit of having the procedure at a hospital: If it’s not safe for a patient to go home after surgery, he or she can stay overnight. “It’s an easy transition,” says Nicole Wilps, program coordinator at the Joint Replacement Center.

After a patient goes home, a nurse will check in with him or her the next day. Patients can choose to receive physical therapy at home or at an outpatient facility. The program, which launched in June 2020, has already seen a steady increase in patients.


Back to Walking


Joan Bennett of Oakhurst was experiencing arthritis-related pain in her right knee and had trouble walking. When the pain failed to improve after cortisone injections, she saw orthopedic surgeon Bert Parcells, MD, who recommended a partial knee replacement.

Joan arrived at Monmouth Medical Center at 5:30 a.m. on June 18, 2020. After the surgery, she spent a few hours recovering, then went to the physical therapy department. “The staff members gave me a walker and showed me how to go up and down stairs,” she says. Joan was then discharged with her husband. She required minimal pain medication and began outpatient physical therapy the next day. “I can bend my knee now,” says Joan, who is taking daily walks and can work in her yard. “The hospital staff was amazing.”


A Quick Recovery


Donna Farina of Wall Township was delighted she qualified for outpatient surgery for her right knee replacement in August 2020. A few hours after her surgery, which was performed by orthopedic surgeon David Chalnick, MD, she found herself in physical therapy, performing tasks such as getting out of a chair and climbing into a bed. “I was proud I was able to do everything,” she says. By late afternoon, she was back home.

After two weeks of at-home physical therapy, Donna went to a nearby facility, where she rode a stationary bike. After six weeks, she was making great strides and was back to walking without pain. “My physical therapist says I’m ahead of schedule,” she says. “I’m so glad I had the outpatient surgery.”


To learn more about the Fast Track Joint Replacement Surgery at Monmouth Medical Center, call 732.923.7971.