The evidence supporting outpatient total hip replacement procedures just got a little bit bigger.
According to Medpage, Gregg R. Klein, MD, presented a study at the American Academy of Orthopaedic Surgeons 2016 annual meeting, which found surgeons can safely and effectively perform total hip replacements in an outpatient setting.
Researchers analyzed 549 patients who underwent mini-posterior arthroplasty at a single ambulatory surgery center and were discharged the same day from 2008 to 2014. Only 0.5 percent of patients were admitted to the local hospital following the outpatient procedure. Additionally, 0.9 percent developed infections, 1 percent had dislocations and 0.5 percent had venous thromboembolism.
Todd Currier, CASC, CMPE, CPA, administrator of Northern Wyoming Surgical Center in Cody, discusses his center's total hip program.
Question: When did you establish the total hip program at the ASC?
TC: We started the total joint program at our center in 2009; however our first total hip procedure was not performed until 2011.
Q: Why did you decide to establish the program?
TC: The success we achieved through our total knee program affirmed our decision to move forward with anterior total hip procedures.
Q: What were some challenges you faced when implementing the program, and how did you overcome them?
TC: Everything has gone relatively smoothly, but as with change of any type, the biggest challenges often center on communication among all those who are affected. Another is involving everybody in the development process.
Q: What has the program achieved since implementation?
TC: The implementation has provided additional convenience to our patients. They no longer have to wait months for available OR time at the hospital for total hip procedures. Our surgeons are pleased with the additional option as well, as it gives them the added benefit of being a part of the program and allows them to participate in the overall care of their patient from beginning to end.
Q: Now that more studies have been published citing the safety of outpatient total hip, how has that affected your program?
TC: We have not noticed an immediate change, but as the studies become more widespread and the knowledge that these procedures can be done safely in an ASC and with high quality outcomes becomes more common, I am sure we will see more cases.
Q: What advice do you have for other ASCs looking to start a total hip program?
TC: Involve everyone in the process of development to ensure that no detail is left out. The surgeons, physician assistants, physical therapists, durable medical equipment providers, vendor representatives and ASC nurses need to be engaged and involved in the implementation for the program to be successful.