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Technology advancements allow outpatient joint replacements at Bone and Joint Institute

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Bone and Joint Institute of Tennessee

Even with the COVID-19 pandemic putting a wrench in everyone’s plans, many people don’t have time to put their fast-paced lives on hold, and when Steve Beal found out he needed a second hip replacement in the middle of the pandemic, his thoughts were no different.

However, when he found out that technology advancements would allow him to go home the same day as his procedure, fully bearing his own weight, and return to his favorite sports and activities in only weeks, the process seemed less daunting.

When Beal started to experience joint pain, he felt like his body was betraying him.

A judge and lawyer in Lexington, Kentucky, by occupation, Beal likes to spend his free time playing basketball, tending to his nearly 60 cattle, and spend long hours quail hunting, but his pain made those activities more difficult.

Beal was referred to Brian Perkinson, a hip and knee expert at the Bone and Joint Institute of Tennessee, where the doctor recommended he get both hips replaced. He started with one replacement and received non-surgical injections in the other hip to prolong his second hip replacement by a few years, and he was back to playing basketball three months later.

However, his mobility eventually declined as the time came to get his second hip replacement.

While this procedure is sometimes performed in a hospital setting, according to Cory Calendine, a hip and knee replacement surgeon at the Bone and Joint Institute, joint replacement procedures are a large focus in the Franklin institute’s state-of-the-art ambulatory surgery center, where Beal was able to get his hip replaced before returning home the same day.

Calendine said while area hospitals have assured patients that it is safe to visit their facilities, the clinic’s surgery center provides another option for patients during the pandemic.

“Other than wearing a mask and answering a few additional questions, there was absolutely no difference in my treatment or care,” Beal said. “If something is causing you pain or discomfort, I would absolutely recommend to go ahead and schedule an elective procedure.”

Calendine said that in his 13 years of practice, he has seen “massive change” in joint replacement technology. Where patients used to have to spend three, four, even five days in the hospital, now they can spend nearly all their recovery time in the comfort of their own homes.

“We let them full weight bear after a hip or knee replacement right away, so many have elected to go home the same day,” he said, adding that most patients use a walker just for balance for a few days and then a cane before they’re on just their feet again.

He said much of the technology advancement has been around pain control. Doctors are able to use regional anesthesia techniques and block nerves to reduce the need for narcotic pain medication.

“We think about narcotics treating pain, but in truth, they have just massive side effects, not to mention the growing concern, of course, about opioid addiction,” Calendine said. “So, we’ve turned to regional anesthesia techniques. What I mean by that — it’s like numbing up the area like the dentist would, if you will, so we’re able to do selective nerve blocks around the joint replacement so that we have to give patients less narcotic pain medicine. … So, they have less pain, and they can do therapy earlier on.”

In addition to pain management and treatment advancements, though, the Bone and Joint Institute is also able to utilize advanced robotic equipment with Mako SmartRobotics technology that allows surgeons to make smaller, fewer and more precise incisions and movements to help speed up the entire joint replacement process.

Calendine said the length of recovery depends on the patient, but typically averages four to six weeks total to return to all normal activities, and “at no point are you down.” He said recovery is an active process, so the faster patients can leave the hospital, the faster they can return to their lives and work.

“Motion is life, and life is motion,” Calendine said, sharing that when pain is preventing motion or when lack of mobility is interfering with life, it’s time to consult a doctor.

“For anyone going 150 miles per hour in their lives, a hip replacement might stop you for a second,” Beal said. “Just remember that it is going to get better, you will get back to normal, and you’ll be a lot more comfortable when you do.”

For more information about the Bone and Joint Institute, visit

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