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Outpatient Orthopedic Surgery: Recover Faster at Home with Your New Knee or Hip

orthopedic surgery

Advancements in orthopedic surgery, notably total hip and knee replacements, have come a long way. Rather than laying in a hospital bed for weeks, patients can now recover in the comfort of their home and most often begin walking within hours of surgery.

With new advances in technology that promote faster recovery, outpatient orthopedic surgery offers many advantages to patients:

  • Higher Satisfaction: Overall, patients prefer outpatient surgery over inpatient and report high satisfaction rates.
  • Better Recovery: Most patients will recover with more ease in the comfort of their own home and get a better night’s sleep, which is essential for recovery.
  • Less Pain: A spinal injection will numb you from the waist down for up to two hours. A long-lasting local anesthetic called a “nerve block” will help control your pain for up to two days post-surgery.
  • Physical Therapy: You will begin working with a physical therapist within a day of returning home after surgery to begin to restore full function to the joint.
  • Lower Infection Risk: The research shows that many infections are acquired in the hospital setting. The less time you spend there, the less risk for infection.
  • Fewer Complications: Research does not show a significance difference in post-surgical complications for outpatient versus inpatient surgery. And some data shows fewer complications with outpatient surgery.

Let’s take a look at the research to support these benefits.

The medical journal Orthopedic Reviews published the results of researchers systematic review of Medline, Pubmed and Embase medical databases for articles comparing the clinical and economic impact of outpatient orthopedic surgical procedures versus inpatient procedures in North America. Researchers found several areas where outpatient orthopedic surgical procedures have potential benefits over inpatient procedures, including patient satisfaction.

The review demonstrated that outpatient surgery participants reported increased satisfaction with the care they received. Additionally, patients reported similar or improved level of pain and rates of nausea with outpatient procedures.

Provider Satisfaction
With regard to care specific to the surgeon in the outpatient setting, The Press Ganey® Outpatient Medical Practice Survey (PGOMPS) – composed of 10 provider-specific and 15 non-provider-specific questions – reviewed all new patient orthopedic PGOMPS scores between January 2014 and December 2017 (5,163 patients).

The data revealed that among orthopedic outpatients, the majority of patients were satisfied with their provider, demonstrating that room for improvement is limited with provider-specific areas.[3]

Fewer Complications and Hospital Readmissions
In a study looking at 90-day complication rates and 2-year patient-reported outcomes of outpatient versus inpatient hip arthroplasty, researchers found that in appropriately selected patients, outpatient total hip arthroplasty can achieve improved postoperative 2-year patient reported outcomes compared to inpatient total hip arthroplasty.

Researchers found no differences regarding postoperative short-term complications or 2-year revision rates, and no differences in unplanned office visits or readmissions.[4]

in patient vs outpatient cost, orthopedic surgery cost comparison

Cost of Care: Outpatient vs Inpatient
Medical costs continue to increase year-over-year – and patients continue to feel the burden of those rising costs more and more. There are many benefits to orthopedic outpatient surgery for you as a patient, if you are a candidate for it.

You’re a strong candidate for outpatient surgery and its benefits if you are:

  • Mobile – If you’re someone who has been active and independent before surgery, you’ll likely respond well to post-op physical therapy. Additionally, you’ll be ready to resume your daily activities as soon as possible.
  • Healthy – If you are generally a healthy person taking few medications, you are likely a good candidate for outpatient surgery.
  • Motivated – If you have a positive attitude and are willing to follow your doctor’s post-surgery instructions and work diligently with your physical therapist, you are a strong outpatient candidate.
  • Supported – Having someone at home to help care for you after surgery is important.

In the event that you are not a candidate for outpatient orthopedic surgery, but want to avoid the hospital setting, our new surgery center is an ideal option for you. We offer options for overnight stay with 24-hour care for those who require it.

In Conclusion
Orthopedic surgery has advanced tremendously in the last decade with new technologies, including robotics, that provide surgeons with advanced tools for improving patient recovery and outcomes. These advances make outpatient orthopedic surgery a viable, safe and effective option for many patients – and one many patients prefer.

References:

[1] Crawford, Dennis C., Silvia Li, Chuan, Sprague, Sheila, Bhandari, Sheila. Clinical and Cost Implications of Inpatient Versus Outpatient Orthopedic Surgeries: A Systematic Review of the Published Literature. Orthopedic Reviews. 2015 Dec 28; 7(4): 6177.

[2] Chandler, Tedder MS, DeBell BS, Henry, Dix BS, Daniel, R. Mith BS, Walter, McGwin Jr. MS, PhD, Gerald, Shah MD, Ashish, Naranje MD, Sameer. Comparative Analysis of Short-Term Postoperative Complications in Outpatient Versus Inpatient Total Ankle Arthroplasty: A Database Study. The Journal of Foot and Ankle Surgery. Volume 58, Issue 1, January 2019, Pages 23-26

[3] Stephens, Andrew R., Rowberry, Tyson J., Tyser, Andrew R., Kazmers, Nikolas H. Evaluating opportunities for improved orthopedics outpatient satisfaction: an analysis of Press Ganey® Outpatient Medical Practice Survey responses. Journal of Orthopedic Surgery and Research. Volume 15, Article number: 28 (2020).

[4] Rosinsky, P.J., Chen, S.L., Yelton, M.J. et al. Outpatient vs. inpatient hip arthroplasty: a matched case-control study on a 90-day complication rate and 2-year patient-reported outcomes. J Orthop Surg Res 15, 367 (2020).

[5] Carey PhD, Kathleen, Morgan PhD, JR, Lin PhD, MY, Kain MD, MS, Creevy, MD, WR. Patient Outcomes Following Total Joint Replacement Surgery. The Journal of Arthroplasty. Volume 35, Issue 1, p7-11, January 01, 2020.

[6] Greenky MD, M. R., Wang MD, William, Ponzio MD, D.Y., Courtney MD, Maxwell.
Total Hip Arthroplasty and the Medicare Inpatient-Only List: An Analysis of Complications in Medicare-Aged Patients Undergoing Outpatient Surgery. Journal of Arthroplasty. Volume 34, Issue 6, June 2019, Pages 1250-1254.

[8] Gregory MD, James M., Wetzig BS, Alexander M., Wayne BS, Colton D., Bailey PT, PhD, Lane, Warth MD, Ryan. Quantification of patient-level costs in outpatient total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery. Volume 28, Issue 6, June 2019, Pages 1066-1073

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