If I live alone, can I go home after joint surgery?

Most patients, even if they live alone, can safely go directly home from the hospital after hip or knee replacement surgery, according to a recent study.

While some patients need to go to a rehabilitation facility to recover, those who go home did not face additional complications, concluded the study, which was published in The Journal of Bone & Joint Surgery.

“Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty,” wrote the lead author, Andrew N. Fleischman, MD, of The Rothman Institute at Thomas Jefferson University in Philadelphia.

The results confirmed what orthopedic surgeon Leonard F. Remia, MD, said he has known for years.

“I’ve been sending patients home for over a decade,” said Dr. Remia of Cape Cod Orthopaedics and Sports Medicine in Hyannis and Mashpee. “I like to get people moving quickly and into their home rehab protocols. If patients are mobilizing, they are going home unless they absolutely can’t go home and have to go to a skilled nursing facility.”

The study followed 769 patients who were discharged home after having a hip or knee replaced. Researchers tracked complication rates and other outcomes for six months for those who lived alone (138 of the total) versus those who lived with relatives or someone else.

Both groups had complication rates of about 8 percent and had similar rates of emergency department and urgent care visits. Almost 90 percent of those who lived alone said they would choose to be discharged home again.

These results should help ease the reluctance about going home alone, Dr. Remia said.

“I understand the fear factor, but I think this study alleviates that,” he said. “It shows they can be successful after surgery, going home alone.

“On Cape Cod, as in the study, most people have either family or friends with them at home. But in my experience over the past 16 years, we have sent lots of people home alone and directly from the hospital without a skilled nursing stay – and those patients do just fine.”

Patients who are frail or have memory issues should not be recovering at home alone, he said.

All of his patients go home with clear instructions on next steps.

“We have a pamphlet on what to do each day, what they should do and what they shouldn’t do,” he said. “Also most patients prepare their home beforehand, and often we will have the home health agency or the physical therapist comes to the house beforehand to do a home safety evaluation.”

Joint replacement patients also attend a preoperative session at the hospital with a nurse who sits with them and goes through what to expect, Dr. Remia added.

Patients who go home alone get assistance at home from nurses and therapists, but “they won’t be there all day, so it’s nice to have friends or family visit,” he said. “In any case, it’s great that this study clearly shows that those patients will be successful.”