What Happens After They Go Home? Early Patient Challenges After Same-Day Discharge Total Hip Arthroplasty.

Background: Same-day discharge (SDD) total hip arthroplasty (THA) offers benefits in cost, recovery time, and patient satisfaction. While SDD THA has demonstrated comparable safety and outcomes to inpatient procedures, there is limited literature on the patient experience during the first 24 hours postdischarge. This study explores patients' self-reported challenges in the immediate postoperative period following SDD. Methods: A survey was administered to a consecutive sample of 616 THA patients at a single high-volume institution between September 11, 2024, and June 10, 2025. The survey asked patients to identify the most significant challenge or concern encountered within the first 24 hours after discharge. Open-ended responses were categorized by 2 independent reviewers. Where appropriate and when subcategories were clearly identifiable, further breakdown of responses was performed. Any discrepancies were resolved by a third independent reviewer. Results: Analysis of 589 valid responses revealed 6 broad categories of challenges. The most reported challenges were pain (29.7%) and mobility (27.5%). A significant subcategory of mobility issues specifically referenced getting in or out of bed (9.2% of all responses). Other concerns included varying medical symptoms (13.6%), logistical challenges (8.3%) including medication management, sleep issues (6.3%), and mental/emotional challenges (3.2%). No challenges were reported by 11.4% of patients. Conclusions: This study identifies the most common challenges faced by SDD THA patients, with pain and mobility concerns being the most frequently reported issues. These findings highlight the importance of tailored preoperative education and postoperative support to address early recovery difficulties and improve patient outcomes in outpatient THA settings.