The number of outpatient TJA programs in the United States is rapidly increasing. • Surgeons must take the necessary steps to run a successful outpatient TJA program. Across the country, there is an increase in same day discharge and outpatient total joint arthroplasty programs. But according to Ugo N. Ihekweazu, MD, FAAOS, FAAHKS, chief of adult hip and knee reconstruction at Texas Orthopedic Hospital and a partner of the Fondren Orthopedic Group in Houston, Texas, the trend is only natural.