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That's an arbitrary limit, but it ensures patients won't be subjected to long car rides after surgery or are too far away from our care in the event issues arise once they've been discharged. Ideal candidates typically present with unacceptable and debilitating hip pain. Patients with dramatic joint deformity or bone deficiency that would require a complex primary replacement or bone grafting are not candidates for same-day discharge. Younger patients, even those in their 30s who have degenerative hips, are champing at the bit to go home the day of surgery. We've also discharged some very healthy 75-year-olds to good home support and they have done quite well. Patient selection is more about comorbidities than birthdays, but in general we focus on very healthy local patients without comorbidi- ties. Patients who are medically compromised or are borderline candi- dates for having the procedures done as outpatient are simply kept overnight. Performing the procedure in the hospital setting affords us that luxury. We schedule same-day joints as the first cases of the morning in 2 ORs. Patients arrive at 6 a.m., roll into the OR around 8 a.m. and are recovering by 9:30 a.m., on the floor, where the first thing their nurses will do is stand them up and walk them to the bathroom. We check on patients between 3:30 and 4 p.m. Patients must feel comfortable, be able to ambulate and agree to being discharged. Their loved ones, the nurse who took care of them, the physical therapist and the operating surgeon all have to agree that the patient is stable and capable of heading home. If pain issues persist past the early afternoon, or patients don't feel comfortable going home, we'll admit them and keep them overnight. These patients typically are ready for discharge the following morning. We always err on the side of caution and never push patients past their comfort zone. Most patients, however, go home the day of surgery, use a walker for about 2 weeks, and are 8 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 6