SAME-DAY JOINT REPLACEMENT · FELLOWSHIP-TRAINED · FRANKLIN, TN
Outpatient Hip & Knee Surgery
in Franklin & Nashville, TN
Outpatient joint replacement allows you to walk into surgery in the morning and recover at home that same evening. Dr. Cory Calendine performs most of his hip and knee replacements at the Bone and Joint Institute of Tennessee Ambulatory Surgery Center in Franklin — a purpose-built orthopedic facility designed exclusively for same-day joint replacement.
SAME-DAY HIP & KNEE SURGERY
What Is Outpatient Joint Replacement?
How Same-day Hip & Knee Replacement Works
Outpatient joint replacement — also called same-day joint replacement — is a hip or knee replacement performed in a setting that allows you to return home the same day rather than staying overnight in a hospital. The surgery itself is the same proven procedure that has restored mobility to millions of patients over the past several decades. What has changed is everything around it: anesthesia, pain control, surgical technique, and recovery protocols have all advanced to the point where most healthy patients no longer need a hospital admission.
Twenty years ago, a knee or hip replacement meant three to five days in the hospital. Today, experts project that more than half of all hip and knee replacements in the United States will be performed on an outpatient basis. The shift is driven by stronger evidence, better outcomes, and patient preference. Dr. Calendine performs most of his outpatient hip and knee replacements at the BJIT Ambulatory Surgery Center on the Williamson Medical Center campus in Franklin, with the option to recover at Williamson Medical Center next door when an overnight stay is the safer choice.
Outpatient Joint Replacement at BJIT Ambulatory Surgery Center
A hospital is built to care for sick patients across dozens of specialties. An ambulatory surgery center is built for one purpose: efficient, safe, same-day surgery. That difference matters more than most patients realize.
The BJIT Ambulatory Surgery Center is a purpose-built orthopedic facility on the Williamson Medical Center campus, designed and staffed specifically for hip, knee, and other orthopedic procedures. The same surgical team works alongside Dr. Calendine for every case — the same nurses, the same anesthesia providers, the same room turnover protocols. That consistency translates into shorter procedure times, lower infection rates than typical mixed-use hospital operating rooms, and a smoother experience from check-in to discharge.
For patients, the practical benefits are immediate. Parking is steps from the entrance. Pre-operative preparation, surgery, and recovery happen under one roof. Family members can wait nearby rather than navigating a large hospital. And because the ASC schedules only orthopedic cases, there are no last-minute delays from emergency surgeries pushing your start time back by hours. When an overnight stay is the right call, Williamson Medical Center is directly adjacent — meaning every patient gets matched to the setting that fits their health profile, not the one the schedule dictates.
THE ADVANCES BEHIND SAME-DAY SURGERY
How Same-Day Joint Replacement Became the New Standard
Outpatient joint replacement is the result of decades of refinement across every stage of the surgical experience. Four advances in particular have made same-day discharge the safer and more comfortable option for the right patient.
Spinal Anesthesia and Regional Pain Control
Most outpatient hip and knee replacements are performed under spinal anesthesia rather than general anesthesia. The hip or knee area is completely numb during surgery, and patients wake up alert, with less nausea and a faster, more natural recovery. Periarticular injections of long-acting local anesthetic placed directly around the joint extend pain control well beyond the procedure itself.
Multimodal Pain Management
Most outpatient hip and knee replacements are performed under spinal anesthesia rather than general anesthesia. The hip or knee area is completely numb during surgery, and patients wake up alert, with less nausea and a faster, more natural recovery. Periarticular injections of long-acting local anesthetic placed directly around the joint extend pain control well beyond the procedure itself.
Tranexamic Acid and Reduced Blood Loss
Tranexamic acid — a medication given before and during surgery — has dramatically reduced blood loss during hip and knee replacement. Blood transfusions, once common, are now rare. Less blood loss means a stronger, faster recovery in the first 24 hours after surgery, which is exactly the window that determines whether a patient can safely go home the same day.
Muscle-Sparing Surgical Techniques and Same-Day Mobilization
Dr. Calendine uses muscle-sparing surgical approaches to preserve the soft tissues around the joint — anterior approach hip replacement and the subvastus approach for knee replacement. By passing between or beneath muscles rather than cutting through them, these techniques allow patients to stand, walk, and climb a few stairs within hours of surgery. Combined with Mako robotic-assisted precision, the result is an implant placed accurately on the first attempt and a patient walking the same day.
WHY PATIENTS CHOOSE OUTPATIENT
Benefits of Outpatient Hip and Knee Replacement
Research over the past decade has consistently shown that outpatient joint replacement is not only as safe as inpatient surgery for the right patient — it is often safer, with measurably better outcomes. For appropriate candidates, same-day knee and hip replacement at an ambulatory surgery center delivers lower infection rates, faster functional recovery, and higher patient satisfaction than the traditional overnight hospital stay.
Lower Infection Rates
Ambulatory surgery centers carry lower hospital-acquired infection rates than mixed-use hospital operating rooms. The BJIT ASC handles only orthopedic surgery, with no exposure to medically complex inpatients.
Faster Recovery at Home
Patients sleep better in their own beds, eat their own food, and recover surrounded by family rather than hospital noise and interruptions. Studies show faster functional recovery for outpatient patients.
Earlier Mobility
Standing & walking within hours of surgery, rather than the next morning, reduces blood clots, urinary tract infections, constipation, and pneumonia. Early movement is a strong predictor of a smooth recovery.
Lower Complication Risk
Outpatient patients show fewer post-operative complications, fewer hospital readmissions, and lower rates of medical events like deep vein thrombosis compared to overnight inpatients.
Higher Patient Satisfaction
Patient-reported satisfaction scores are consistently higher for outpatient joint replacement, especially when expectations are clearly set during pre-operative education.
Lower Out-of-Pocket Costs
Outpatient procedures are generally less expensive for patients and insurers than inpatient surgery, with shorter facility time and reduced overhead.
IS SAME-DAY SURGERY RIGHT FOR YOU?
Who Is a Candidate for Outpatient Joint Replacement?
Outpatient joint replacement is appropriate for most healthy patients with hip or knee arthritis — but not every patient. Dr. Calendine evaluates several factors during your consultation to determine whether same-day surgery is the safest option for you, or whether an overnight stay at Williamson Medical Center is the better choice.
Strong Candidates for Same-Day Surgery
- Generally good overall health, without uncontrolled heart, lung, or kidney disease
- No untreated obstructive sleep apnea
- Reasonable mobility before surgery (able to walk with or without an assistive device)
- A support person available at home for the first 24 to 48 hours
- Motivation to participate in the recovery plan and follow post-operative instructions
- A home environment that allows safe movement (manageable steps, accessible bathroom, clear walking paths)
Age, by itself, is not a disqualifying factor. Dr. Calendine has performed successful outpatient hip and knee replacements on patients in their 70s and 80s. What matters is your overall health profile, not the number on your driver’s license.
When an Overnight Stay Is the Safer Choice
Patients with significant cardiac disease, advanced lung disease, kidney failure or dialysis, severe obstructive sleep apnea, or limited home support are typically safer with an overnight admission at Williamson Medical Center. The conversation about which setting fits your situation is part of every pre-operative visit, and the recommendation is always made with your safety as the priority — never the schedule.
Outpatient Hip Replacement
Dr. Calendine performs most of his hip replacements using the direct anterior approach — a muscle-sparing technique that accesses the hip joint between the muscles rather than cutting through them. The gluteal muscles remain entirely intact, traditional hip precautions are eliminated, and most patients are walking with a walker the day of surgery. Combined with spinal anesthesia, periarticular injections, and the streamlined ASC environment, the anterior approach makes same-day discharge a realistic option for the majority of hip replacement candidates. Patients typically arrive in the morning, complete surgery in approximately 60 to 90 minutes, walk a short distance with the physical therapy team in recovery, and return home the same afternoon.
Outpatient Knee Replacement
For appropriate candidates, Dr. Calendine performs total knee replacement using the subvastus approach — passing beneath the quadriceps muscle rather than cutting through it. Combined with Mako robotic-assisted precision and modern pain control, the subvastus technique delivers faster quad recovery, less early pain, and earlier independence in the critical first weeks after surgery. Outpatient knee replacement requires the same careful candidate selection as outpatient hip replacement. Patients who meet the criteria typically arrive in the morning, complete surgery within approximately 60 to 90 minutes, work briefly with physical therapy, and return home the same day with a clear plan for the first week of recovery.
YOUR DAY AT THE BJIT ASC
What to Expect on Your Surgery Day at the BJIT ASC
A typical outpatient joint replacement day moves quickly and predictably. Most patients are home within four to six hours of arrival.
You arrive at the BJIT ASC, complete final paperwork, and meet the surgical team. A family member can stay with you through pre-op preparation.
The anesthesia team places your spinal anesthesia and any regional nerve blocks. You receive tranexamic acid to minimize blood loss. Dr. Calendine reviews the surgical plan with you one final time.
Hip or knee replacement is performed using your personalized surgical plan, with Mako robotic-assisted precision when indicated.
You wake up in the recovery area, your spinal anesthesia begins to wear off, and the physical therapy team gets you standing and walking a short distance. Pain control is reassessed before discharge.
You leave with a clear medication plan, written instructions, your physical therapy schedule, and direct contact information for the on-call team. A family member or friend drives you home.
Most patients are surprised by how quickly the day moves and how comfortable they feel at home that first evening — sleeping in their own bed, eating their own food, and starting recovery on familiar ground. Outpatient hip and knee replacement is designed around exactly this outcome: a smooth, predictable surgery day that ends where recovery happens best.
COMMON OUTPATIENT QUESTIONS
Frequently Asked Questions About Outpatient Joint Replacement
Is outpatient joint replacement safe?
Yes — for the right patient, in the right setting. Multiple large studies have shown that outpatient hip and knee replacement is as safe or safer than inpatient surgery, with lower infection rates and fewer complications. Patient selection is the most important factor. Dr. Calendine carefully evaluates your overall health, home support, and mobility before recommending same-day surgery.
What is the difference between outpatient and inpatient joint replacement?
The surgery itself is identical. The difference is where you recover immediately afterward. Outpatient patients return home the same day, typically within four to six hours of arrival. Inpatient patients stay overnight in the hospital. For healthy candidates, recovering at home is generally more comfortable, lower-risk, and associated with faster functional recovery.
How long does outpatient joint replacement surgery take?
The procedure itself typically takes 60 to 90 minutes. Including pre-operative preparation, anesthesia, surgery, and post-operative recovery, most patients are at the BJIT ASC for approximately four to six hours total before discharge.
Will I have pain at home after same-day joint replacement?
You will have some discomfort, but modern pain control protocols make it manageable for most patients. Spinal anesthesia and periarticular injections provide hours of pain relief after surgery, and a multimodal medication plan — combining acetaminophen, anti-inflammatories, and a small amount of short-term opioid medication — bridges the rest of the first week. Most patients are surprised by how well-controlled their pain is at home.
What if I am not a candidate for outpatient surgery?
If outpatient surgery is not the safest option for you, Dr. Calendine performs hip and knee replacement at Williamson Medical Center, directly adjacent to the BJIT ASC. The surgical technique, implants, and quality of care are identical. The only difference is an overnight stay for additional monitoring. Every patient receives the plan that fits their health profile.
Where does Dr. Calendine perform outpatient joint replacement?
Dr. Calendine performs outpatient hip and knee replacement at the Bone and Joint Institute of Tennessee Ambulatory Surgery Center, located at 3000 Edward Curd Lane in Franklin, TN, on the Williamson Medical Center campus. The ASC is a purpose-built orthopedic facility designed exclusively for same-day surgery, just off I-65 Exit 65 and convenient to patients throughout Nashville, Brentwood, Murfreesboro, Spring Hill, and Nolensville.
Is outpatient joint replacement covered by Medicare and private insurance?
Yes. Medicare and most major commercial insurance plans cover outpatient hip and knee replacement performed at an ambulatory surgery center. Coverage details vary by plan, and our team will verify your benefits before surgery so there are no surprises. In many cases, outpatient surgery results in lower out-of-pocket costs than the same procedure performed inpatient.
How do I schedule a consultation for outpatient hip or knee replacement?
You can request an appointment online or call the office directly at (615) 791-2630. No referral is required. Dr. Calendine sees patients at the Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067, serving patients throughout Middle Tennessee.
Real Patients, Real Experiences
Pauline Chadwick,
aka *LSU Gami
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A Complete Guide to Hip & Knee Replacement | Schedule Your Outpatient Joint Replacement Consultation
If hip or knee arthritis is keeping you from the activities and people that matter most, a consultation with Dr. Calendine is the first step toward understanding your options. Outpatient joint replacement may be the right path forward — and even if it is not, you will leave the conversation with a clear plan, an honest assessment, and a surgeon who has helped thousands of patients across Middle Tennessee return to active, pain-free living.