Who goes home
Stable heart and lungs. Diabetes under control. A coach at home. A house that does not require a mountain. You will know before the day, not at 4 p.m. with a suitcase in your hand.
Treatments
The operation is the middle of the story. The life is the point.
One question at the first visit: what do you want to be able to do in six months that you cannot do this morning?
00 · Before replacement
Not ready for surgery?
Many people start with conservative care for hip and knee arthritis: activity, physical therapy, medicines, injections, and selected advanced options at UHealth. Dr. D’Apuzzo maps the plan. Colleagues carry out most non-surgical visits. You come back here to talk about replacement when you want that conversation.
01 · Hip
Total hip replacement
The ball and socket are worn to bone. We replace both with a smooth bearing that does not grind when you turn in bed. Some patients go home the same day when it is appropriate. Others stay overnight. Same-day discharge is a pathway, not a promise.
The usual approach is minimally invasive posterior / piriformis-sparing, when your anatomy allows. This is not an anterior or “bikini” pitch.
- —Groin pain that ends a walk at two blocks.
- —A limp you can no longer hide in a restaurant.
- —Nights spent looking for a position that does not wake you.
The goal is not an x-ray. The goal is the boardwalk, the grandchild, the side of the bed you abandoned.
02 · Knee
Total and partial knee replacement
If one compartment is worn and the ligaments are honest, a partial replacement can spare the rest of the joint. If the whole surface is finished, a total knee — aligned to your anatomy, often with the robot — is the cleaner answer.
Stiffness, swelling after a chair, pain that makes you choose the car over two blocks: these are not character flaws. They are cartilage that is gone. The operation is designed so you stop thinking about the knee, which is the highest compliment a knee can be paid.
03 · Same day
Outpatient joint replacement
Hospital is not a virtue. For the right patient — medically optimized, home support in place, motivated — hip or knee replacement can be a morning operation and an evening in your own bed. This is not a shortcut. It is a pathway that is stricter, not looser, than a two-night stay.
What makes it safe
Modern anesthesia, multimodal pain control, blood-clot prevention, and a written rescue plan. Quality and Safety is not a title on his door. It is the design of the day.
What you do the night before
Eat the meal we told you. Pack the list we sent. Sleep. The work of getting ready happened in the weeks before, not at 5 a.m.
04 · Precision
Robotic-arm assisted surgery
Imaging can become a three-dimensional model of your hip or knee. The robotic arm helps plan and guide bone work. Dr. D’Apuzzo stays in control. The robot does not operate on its own. It is used for many primary replacements.
- It does not operate. Dr. D’Apuzzo operates. The arm helps him stay with the plan he wrote.
- It is not theater. He publishes on when technology reduces complications — and when it does not. He will tell you which case yours is.
- It is how many of his primary hips and knees are done. Including selected same-day cases.
05 · Preserve
Avascular necrosis and joint preservation
When the bone loses its blood supply, there is a clock. Early, we can try to save the native hip or knee — core decompression, grafting, realignment, the procedures that delay or avoid a replacement. Late, when the surface has already collapsed, a well-done replacement is not giving up. It is refusing to let a dead segment of bone write the rest of your life.
If someone has told you that you are “too young for a hip,” come anyway. Youth is a reason to do it well, not a reason to limp for a decade.