Matthew Price, MD, an orthopedic surgeon practicing at Louisville, Ky.-based Ellis & Badenhausen Orthopaedics, shared his experience transitioning to outpatient total hip arthroplasty in ASCs and hospitals on Exactech's blog.
Here are the insights Dr. Price shared:
1. Determining which patients are good candidates for outpatient surgery is part of the preoperative evaluation Dr. Price uses before surgery.
"All patients are assessed preoperatively by both services for proper clearances, lab studies and further work-up if needed. Patients with comorbidities, which might lead to untoward events, are not considered for an outpatient procedure," he said. "ASA scores of three or greater are automatically marked as overnight stays."
2. On the day of surgery, patients at Dr. Price's clinic receive anesthesia through epidurals with catheters, and undergo a multimodal approach for pain control, including 200 mg of Celebrex, 300 mg of Gabapentin and 400 mg of IV Acetaminophen.
3. Before patients are discharged, Dr. Price said the three goals the patient needs to achieve are: walking more than 75 feet, climbing stairs and voiding urine.
4. The clinician should follow up with the patient within four weeks after surgery for radiographs and wound checks. After three months, physicians follow up with patients, and have a check-up one year after the surgery.