The American Association of Hip and Knee Surgeons, Hip Society, Knee Society and the American Academy of Orthopaedic Surgeons published their stance on outpatient joint replacement in the Journal of Arthroplasty.
Here are the key details to know:
1. When institutions establish an outpatient total joint program, they should aim to focus their programs on quality and safety outcomes, including minimizing complications, discharging the patient to a safe environment and maximizing patient safety.
2. Surgeons and their institutions should also acquire the appropriate data and insights regarding their ability to perform outpatient joint replacement.
3. An outpatient total joint program requires optimization of these essential elements:
● Patient selection
● Patient education
● Social support
● Surgical and clinical team expertise
● Surgery center factors, such as a facility that optimizes surgical outcomes and a history of successful teamwork
● Evidence-based protocols and pathways for blood conservation, wound and pain management
4. Medical comorbidities should be minimal, and patients should eb healthy, active and at low risk for medical complications.
5. If the surgery is performed at an ASC, establish protocols for responding to intraoperative and perioperative complications.
6. Organizations should also track outcomes and embrace quality improvement efforts after a program is established.