21 July 2016

Key Considerations for Performing Outpatient Total Joint Replacements at Ambulatory Surgery Centers

According to a recent article in Becker’s ASC Review, orthopedic procedures, especially, total knee and hip replacement surgeries, are among the most popular surgical services performed at ambulatory surgery centers (ASCs). The publication interviewed Sheridan anesthesiologist Cameron Howard, M.D., who described some of the key considerations in doing these types of procedures as outpatient surgeries successfully.

Dr. Howard explained that although it is much more cost-effective to do these procedures on an outpatient basis, it is desirable for some patients – e.g., middle aged, non-obese, with no significant medical problems – but not for all. For example, an inpatient setting may be preferable for patients who are morbidly obese, brittle diabetics and patients with cognitive decline.

The other key consideration is whether the family has a support system in place, “with family or friends to help them with ambulating, transferring and transporting them to outpatient rehab,” Dr. Howard said. Inpatient surgery may also be a better option for patients who don’t have that type of support system.

Dr. Howard also said that a comprehensive program that includes extensive preoperative training is required for successful outpatient total joint surgeries. Patients need understand that they will have some pain, and must be educated about the complication risks related to joint replacements.

He also discussed the role of anesthesia and pain management in outpatient joint replacement.

Read more about Dr. Howard’s views on this topic in the Becker’s ASC Review article, “Outpatient TJR rests on these 2 pillars — Sheridan's Dr. Cameron Howard weighs in.”