Adequate pain management is absolutely essential to allow rapid recovery of patients after joint replacement surgery. With modern protocols, most patients have minimal pain postoperatively and can progress rapidly with learning their rehab program. They can be discharged from the hospital within one to two days after the surgery and can now even have outpatient surgery without a hospital stay.
It is best to minimize hospital time to avoid complications. A stay in the rehab unit after hospital discharge is totally unnecessary, except for selective elderly or severely debilitated patients who have no family support at home for one to two weeks. Even privately hiring a home health aide is preferable. Rehab/hospital stays expose patients to additional risks in my opinion.
A multi-modal pain management system decreases narcotic requirements and results in less pain with fewer side effects. Significant pain postoperatively is now generally only experienced by a small percentage of patients with a low pain tolerance or by patients that are already habituated or addicted to prescription narcotics before surgery.
There is a safety limit to narcotics that can be administered postoperatively. With the following multimodal pain management program, we can usually eliminate most pain postoperatively without reaching this limit.