Tina Hartlaub was the very first patient to get her knee replaced in a same-day procedure at the WellSpan Health & Surgery Center in Hanover, back in December. Tiffany Jackson was the second.

Both women were back home just hours after surgery by WellSpan orthopedic surgeon Dr. Albert Folgueras, following some physical and occupational therapy that involved practicing walking with a walker and cane and going up and down stairs.

The most telling reaction to their outpatient knee replacement might be this: Both women plan to come back to the Hanover surgery center to get their other knee replaced, also in a same-day procedure.

"I was happy to come home," says Tiffany. "We had decorated for Christmas. I could sit and my family could take care of me. I will do my other knee the same way."

Says Tina: "This way I got to be in the comfort of my own home."

The Hanover center is home to more than a dozen primary care, specialty care, surgical, and ambulatory services care for patients, all under one roof. It's the first WellSpan outpatient surgery center to provide same-day total joint replacements for knees and hips, starting with knee replacements and now offering hip replacements.

The outpatient center joins five WellSpan hospitals that offer outpatient joint replacements. In the past year, 21% of total joint replacements were done on a same-day basis at these hospitals, which include WellSpan Chambersburg Hospital, WellSpan Ephrata Community Hospital, WellSpan Gettysburg Hospital, WellSpan Good Samaritan Hospital, and WellSpan Surgery and Rehabilitation Hospital.

With increases in patient demand for outpatient joint replacement, the American Academy of Orthopaedic Surgeons predicts that 51% of total joint replacements will be performed in an outpatient setting by 2026.

"Having outpatient joint replacement surgery available across our region allows us to meet the needs of patients in their own communities," Dr. Folgueras says. "Having it available at Hanover just increases our capacity to do that."

Several factors have led to the increase in availability of outpatient joint replacement.

The shift has been made possible by our adoption of innovative approaches to post-surgical care, and more effective means of pain control. Patient education also is key. At WellSpan, almost 100% of our patients participate in "joint class" to learn about the process and ask questions. All patients receive guidebooks as well as a one-on-one phone call with a care coordinator.

"Not all patients are candidates for same-day discharge surgeries," Dr. Folgueras notes. "Those who would benefit are usually younger, more active patients, who are otherwise healthy."

Both Tina and Tiffany have osteoarthritis, which runs in their families. Tiffany, 49, who is a WellSpan nurse midwife, first injured one of her knees dancing. Tina, 55, who works in medical billing for a private company, played softball and grew up with knee pain, which got worse in the past dozen years or so. Both women tried other therapies, including injections and physical therapy, before opting for surgery.

Both had discomfort after the surgery, but Tina notes that would have happened whether she had stayed in the hospital or gone home the same day.

"It was nothing I couldn't handle," she says.

Both women are back at work and resuming their normal schedules. Tina likes to cook, swim, and play with her kids and grandsons, and she's eager to get back on a hiking trail. Tiffany is back to walking the halls of WellSpan York Hospital and also working out on her exercise bicycle. She's looking forward to the day when she has two "new" knees.

"I am going to get my other knee done," she said. "I hope I will go in a year, if I can wait that long."

Check out all of the services, including same-day surgery, offered in Hanover here.