In and out: Hip surgery in the morning, home by night

New surgical techniques for total hip replacement and innovative pain management protocols are allowing patients to recuperate in the comfort of their own homes.

Dr. Roy Davidovitch describes his one-day hip transplant approach.Ed Dowling

Americans are wearing out their joints and requiring total hip replacement surgery at increasingly younger ages — some as early as 40.

Total hip replacement, a surgical procedure in which the head of the femur and its socket are replaced, is one of the most common surgeries performed in the United States. Over 340,000 people get a "new hip" each year to treat chronic pain and mobility issues caused by age-related wear and tear, arthritis, fractures, and other conditions.

Traditionally, patients face a lengthy and sometimes difficult recovery — an average of four days in the hospital, with follow-up care in a rehabilitation center.

New York pediatrician Julie Luttinger, 55, dreaded a second hip replacement — her first was twelve years prior and she had to miss six weeks of work.

“I live in the city. I walk to work every day and I walk my son to school. I couldn't do that anymore,” Julie said. “To make matters worse, I felt guilty about abandoning my colleagues again.”

Fortunately, a new nontraditional approach pioneered by Dr. Roy Davidovitch, orthopedic surgeon at NYU Langone Health, is promising patients a quicker short-term recovery time. Many patients even leave the same day.

Dr. Julie Luttinger and son Bobby Luttinger meet with Dr. Roy Davidovitch prior to surgery to discuss the details of her same-day hip replacement surgery.NYU Langone Health

"Younger, active patients tend to be in the work force and a lot of them own their own businesses. They want to get back to work,” said Davidovitch. “With this approach they can come in the morning, have the operation, and be done sometime before noon. They go home sometime around 5, 6 o'clock in the afternoon."

The same-day procedure uses a smaller, 3-inch incision and the minimally invasive technique on a specialized surgical table results in less damage to the muscles around the hip and less post-operative pain. Muscles and tendon are not cut to access the hip, allowing patients to be relatively functional right away. This leads to faster recovery.

The procedure generally leads to quicker short-term recovery. Ultimately, most patients recover after three to six months no matter which procedure is used.

The average cost of the same-day procedure and the traditional hip replacement is about the same — an estimated at $40,364, in the U.S. according to Blue Cross Blue Shield of North Carolina. Both are coverd by most insurance companies.

Eligible patients are typically under age 65, healthy and active. Certain health conditions such as heart disease, chronic liver disease, uncontrolled diabetes, and obesity may make the procedure too risky.

Related: Hips Don’t Lie: Replacements on the Rise As Busy Boomers Age

Currently, only a limited number of doctors have been trained in the new approach, but Davidovitch believes that it will become more routine as more academic medical centers teach residents how to perform the same-day operation.

Dr. Roy Davidovitch describes his one-day hip transplant approach.Ed Dowling

Luttinger, who underwent her same-day hip replacement in February was not only out of the hospital within 24 hours but returned to work in just two and a half weeks. Her hip isn’t completely healed, but she’s able to do many of the activities she loves.

"I am very grateful to be able to be back at work full time and that don’t have to I think about this anymore. I look forward to being active pretty much the way I was 3 years ago,” she said.