Stephen Kayiaros, MD, is an orthopedic surgeon with University Orthopedic Associates in Somerset, N.J. He concentrates on joint replacement and traumatology. Dr. Kayiaros earned his medical degree from the University of Medicine and Dentistry of Robert Wood Johnson Medical School in New Brunswick, N.J. He completed his internship, residency and fellowship at the Warren Alpert School of Medicine at Brown University in Providence, R.I. Dr. Kayiaros completed an additional fellowship in adult reconstruction and joint replacement at the Hospital for Special Surgery in New York.
Here, Dr. Kayiaros discusses the movement of joint replacement to the outpatient setting.
Q: What are a few of the most important things that orthopedic surgeons should understand about outpatient joint replacement?
Dr. Stephen Kayiaros: I think the most important factor about outpatient joint replacement surgery is patient selection. This will play the biggest factor in ensuring a successful outcome. In addition to being highly motivated, the ideal candidate should be medically healthy and physically fit to be able to recover from joint replacement surgery as an outpatient.
Another important factor is coordinating all the services involved to make sure the patient has the best experience and ultimately outcome. This includes the surgeon and their team, the anesthesiologist, the surgical center staff, physical therapist, visiting home nurse, as well as the support structure that the patient will have at home, or the rehabilitation facility should the patient opt for that.
Q: What are the advantages of joint replacement in the outpatient surgery setting?
SK: The major advantage is that the patient can undergo surgery and bypass a hospital stay, which can potentially expose otherwise healthy patients to hospital acquired infections and other complications.
Q: What are a few of the challenges?
SK: Joint replacement surgery is still a major orthopedic procedure and patients need to be carefully monitored in the immediate postoperative period. The biggest surgical challenge is controlling postoperative pain. With advanced multimodal protocols and careful patient selection we are able to minimize the potential hurdles.
Q: How do you think the trend of outpatient orthopedic surgery will continue to affect the field?
SK: Joint replacement surgery is undergoing dramatic improvements. From minimally invasive techniques to advanced anesthesia and multimodal pain control protocols, we are continuing to strive to perfect this already excellent surgery. As younger patients are now requiring joint replacement there will be a trend to push joint replacement more so to the outpatient setting than ever before. What was once considered a potentially long hospital stay will now be viewed as an outpatient procedure.
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