• Same day total joint replacement (TJR) is when a patient has TJR surgery and goes home from the hospital the same day, without staying even one night.
  • Studies show that people are more satisfied after TJR surgery when they recover at home versus in a hospital.
  • According to Mark Fletcher, MD, Orthopedic Surgeon, patients of all ages can go home the same day of their TJR, as long as they are in overall good health, motivated, and have good home support.           

Newswise — NORWALK, Connecticut, January 31, 2019 — Iliana Zúñiga-Miranda had just finished running her 12th half marathon when her hip started clicking. She went to the doctor, had X-rays, and received a diagnosis of advanced osteoarthritis (OA). She was only 39 years old.

OA is a common degenerative joint condition that occurs when the cartilage that provides cushioning between the bones and the joints wears away. OA causes pain, stiffness, and joint damage. OA can occur at any age, but it is most common in people age 65 and older.

“I couldn’t believe I would need a hip replacement at my age,” said Iliana, an active mother of two young boys. Several years prior to the diagnosis, during her second pregnancy, she had experienced some hip pain and thought it was pregnancy-related. The news that she had severe arthritis took a while to sink in.

For about two years after the diagnosis, Iliana tried non-surgical treatments, including cortisone injections and physical therapy. But her condition did not improve. She arrived at a point where she could only walk one block before she started to feel pain.

Hip Replacement Offers Hope

Finally, Iliana had a consultation with Mark Fletcher, MD, an orthopedic surgeon at Western Connecticut Health Network’s (WCHN) Norwalk Hospital.

Iliana discussed with Dr. Fletcher where she wanted to be in 25 years, and whether hip replacement surgery now was the best option for her.

“Dr. Fletcher was so helpful. He asked me a lot of questions, and he put himself in my shoes. He assured me that after a hip replacement, I could get back to doing the things I was used to doing, and without pain,” said Iliana.

Given that Iliana was so active, was otherwise in overall good health, and had strong support from her husband, Dr. Fletcher proposed a same day TJR surgery, which meant that she would be able to go home right after the operation. Iliana agreed.

Benefits of Same Day Total Joint Replacement

According to Dr. Fletcher, Iliana was a great candidate for same day TJR. Even patients who are in their 70s are capable of going home the same day, as long as they are motivated, they have good home support, and don’t have any other health problems that would need to be monitored in the hospital.

“Data has shown that people recover better at home versus a hospital or rehab facility after joint replacement surgery. We want our patients to get up, get moving, and go home as long as they feel ready and it is safe for them to do so,” said Dr. Fletcher.

Dr. Fletcher said that a majority of his patients can go home the day of their surgery. The reason why is that the procedures for TJR surgeries have improved significantly over the last decade.

“Five or six years ago, our average hospital stay was about three days. Two years ago, it was almost one day. After you get to that point, you can identify that there are people out there who don’t even need to be in the hospital, like Iliana,” said Dr. Fletcher.

One of the reasons patients can go home earlier is the improvement in pain management practices. Now, through collaborative medicine, multimodal pain management allows patients to get moving as soon as possible after surgery. Combination pain management therapies include local anesthesia around the site of surgery, intravenous acetaminophen, anti-inflammatory medication, and ice.

Another reason many patients don’t require hospitalization is that surgeons have been improving their techniques. Although the basic method of doing a hip replacement has not changed, many small improvements in the procedure can make a big difference.

“As we’ve become better and better, just by repetition of the surgery, patients experience less trauma overall,” said Dr. Fletcher.

Further, more patient education has contributed to reducing a patient’s hospital stay after surgery.

“We want our patients to be engaged throughout the entire process, which includes pre-operative patient education so they understand what will happen before, during, and after surgery. This gives them the tools they need to get their quality of life back after joint replacement surgery,” said Dr. Fletcher.

Hear more from Dr. Fletcher in this video.

After Hip Replacement Surgery

In February 2018, Iliana had same day TJR surgery at Norwalk Hospital. Her surgery was at 7:30 AM. At the hospital, one hour after the operation, she was up and walking with a walker. That same afternoon, when her older son came home from middle school, Iliana was standing in the doorway, waiting for him.

Iliana recovered from her surgery with remarkable speed. After just two and a half days, she was able to walk without the walker.

One of the other benefits of same day TJR is that physical therapy starts right away, on the same day as the surgery. As soon as Iliana returned home, she began working with an in-home physical therapist. Her recovery was so swift that she was able to switch to outpatient physical therapy after only a few weeks.

The hip replacement completely eliminated Iliana’s pain, to the extent that just four months after surgery, she was back to her normal activities.

“I was living with a lot of pain for about two years because of the arthritis in my hip. I couldn’t believe that I wasn’t in pain right after the surgery — I felt better than I did before going into the operating room,” said Iliana.

Iliana said Dr. Fletcher and the Norwalk Hospital joint replacement team helped her get back to the activities she loves.

“I’m a very active person as a mom of young boys, and I also work full time. I love to exercise. I stopped being who I was for those two years before surgery. The hip replacement surgery enhanced my life in every single way,” said Iliana.

Iliana was selected to be a participant in a Project Athena event. Project Athena helps people who have experienced a medical or other traumatic challenge reach new athletic goals and achieve their adventurous dreams. Iliana has been training for this fundraising event which will take place in November 2019. Go Iliana!

Hear more from Iliana in this video.

About Norwalk Hospital Joint Replacement Center

Norwalk Hospital Joint Replacement Center is a nationally certified Center of Excellence. The center is exclusively dedicated to total joint replacement patients, and our multidisciplinary team includes board-certified orthopedic surgeons, physician assistants, orthopedics-certified nurses, physical and occupational therapists, and a joint care coordinator. We use the latest multimodal pain management techniques to ensure your comfort. We have you up and moving within hours after surgery, helping you recover faster and go home sooner. To learn more about Norwalk Hospital's Joint Replacement Center, visit our website.

Catch up on the latest news at WCHN. Visit today!

About Western Connecticut Health Network

Western Connecticut Health Network is the region’s premier, patient-centered healthcare organization serving residents of western Connecticut and adjacent New York. WCHN is anchored by three nationally recognized hospitals, Danbury Hospital, New Milford Hospital, and Norwalk Hospital. We have an integrated network of more than 1,300 employed and community physicians and specialists, 70 Western Connecticut Medical Group medical and sub-specialty practices across 16 communities, and Western Connecticut Home Care. Our nationally renowned Rudy L. Ruggles Biomedical Research Institute is leading innovative research, especially for cancer and Lyme disease. Many of our advancements have been made possible by generous donors from our community and through the Danbury Hospital & New Milford Hospital Foundation and the Norwalk Hospital Foundation. As an academic institution, we are proud to shape the future of care through our partnership with the University of Vermont Larner College of Medicine. WCHN employs nearly 6,300 employees including about 1,900 clinical staff. For more information, visit Share your comments with us at,, and