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Market Shifts Facilitate Same-Day Joint Replacement

Posted in Practice Management Solutions | Oct 2015 | Comments (0)

Tags: Editor's Choicehip replacementorthopaedic surgeryorthopaedic industry trendsorthopaedic surgeonoutpatient orthopaedic surgeryhealthcare in americakneehipsame-day joint replacement

    Dr _Barrington_smaller     Keith Berend_smaller           Dr. Timothy_J_Henderson_crop  John Wang_2015_crop_copy

John Barrington, M.D.  

   Keith Berend, M.D.

  Timothy Henderson, M.D.

 John Wang, M.D.

As demands for joint replacement surgery rise due to an aging population, consumers seek out less invasive and less costly treatments, and hospitals and payors adopt risk-based models like bundled payments, same-day joint replacement surgery stands to experience further growth.

Though traditional joint replacement surgery is known for its effectiveness, the following data suggests that same-day or outpatient joint replacement surgery is on the rise.

A Duke University study showed that from 2007 to 2011, outpatient total knee replacements increased by nearly 20 percent, total hip replacement by almost 40 percent and partial knee replacement almost 70 percent, according to Keith Berend, M.D., an orthopaedic joint replacement surgeon at Joint Implant Surgeons, Inc. in Columbus, Ohio.

The strongest data is currently available for unicompartmental knee replacement which, “given its minimal blood loss and maintenance of intact ligaments, lends itself perfectly to outpatient surgery,” says John Barrington, M.D., an orthopaedic joint replacement surgeon at Plano Orthopedic Sports Medicine and Spine Center in Plano, Texas.

While same-day joint replacement procedures are indeed studied at length and alluded to frequently in the patient information found on the web sites of numerous clinics, data isn’t readily available that indicates the proportion of all total hip and total knee replacements that are presently performed on an outpatient basis, nationwide.

John Wang, M.D., an orthopaedic joint replacement surgeon at Atlantis Orthopaedics in Florida, expects the number of outpatient joint surgeries to rise as the healthcare system addresses a higher demand for joint replacements and discovers how to make these surgeries more effective from outcomes and cost analysis.

“There’s only a certain amount of money we can spend on joint replacement as a nation, so surgeons and scientists have been trying different ways to improve this surgery,” Wang says. “The potential financial implications will come in the form of decreasing overall cost into the system. If you could shorten length of stay down to eight hours, that would obviously cost the insurance companies and/or Medicare less money than if a patient stayed for a week. From that perspective, there are huge implications for decreasing costs in the face of this increased demand for joint replacement over the next decade or two.”

Also, performing same-day joint replacement at surgery centers that are associated with less bureaucracy and more efficiency compared to hospitals can benefit surgeons’ profitability, according to Berend.

“There’s lower overhead at a more agile facility, such as a surgery center,” he says.

Costs aside, same-day joint replacement has the potential to improve patient outcomes and satisfaction by reducing pain and getting patients back to their lives sooner through a faster procedure and recovery.

Wang has found that his patients recover faster when they undergo same day joint replacement in the outpatient setting.

“In my experience, the patients I’ve done at a surgery center somehow mobilize faster,” he says. “I don’t know if it’s because they have more independence sooner, but patients – especially those who have had one site done in a hospital and the other site done at a surgery center – always come back and feel like they’re further along in their recovery at the two-week and six-week periods.”


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