The Transition of Joint Replacement to Same-Surgery

Aug 5, 2019

For years, joint replacement has traditionally been an inpatient surgery where patients would spend several nights in the hospital receiving postoperative care including physical therapy and pain management. The advent of improved surgical techniques, regional anesthetics and the addition of local anesthetics into the surgical field have revolutionized the recovery from knee, hip and shoulder replacement allowing patients immediate unrestricted mobility for a majority of cases. As outcome studies began to reveal the benefits of early mobilization to overall recovery, and as improved pain control supported this trend, it became increasingly apparent that several-day stays in the hospital were no longer necessary for a majority of patients. Slowly the average inpatient stay went from 4 days to 3 days to 2 days to 1 one day. And now, many patients can go home just hours after surgery with appropriate patient education, home preparation, health optimization and adequate home support.

Our practice pioneered this transition to outpatient surgery several years ago, well before any other regional programs had reached this level of care coordination. By working the appropriate care providers along the continuum of joint replacement care, we have perfected this process through over 1200 cases, hundreds more than any other practice in New England. Our AVATAR joint replacement process is an outcomes focused, accelerated recovery pathway that engages patients in their own success and earlier return to home is an enabling accomplishment that leads to better comfort, better sleep, better nutrition and higher patient satisfaction.

As joint replacement surgery has transitioned to the outpatient setting, patients with commercial insurance can have surgery performed at ambulatory surgery facilities that specialize in such cases. Research has proven that this is just as safe as hospital based care and that complication rates are actually lower including infections and readmissions to the hospital. Medicare has yet to approve the transition of joint replacement out of the hospital and into the ambulatory setting but recognizes the safety and cost effectiveness of this approach. The anticipation is that Medicare may approve this transition in early 2020.

Our practice is the leader in this field and we have the numbers to support the benefits of this approach. If you are considering joint replacement surgery, put our AVATAR program to work for you.