Thinking about an entire joint in your body being removed and replaced by prosthetic parts still seems a bit like science fiction to me. However, for nearly 70 years, hip replacements have been common practice and for over 42 years, knee replacements have been helping people walk without pain. This long history means physicians are constantly improving methods, materials, and patient outcomes.
These improvements have, in recent years, enabled doctors to offer outpatient total joint replacement surgery as an option for qualified patients. No overnight hospital stays are welcomed by patients, families and physicians alike.
Olympia Orthopaedic Associates has been a leader in total joint replacement in southwest Washington since their founding over 30 years ago and construction of their West Olympia Surgery Center in 2012 has opened the door for this new outpatient option.
“March 2016 was our one-year anniversary offering this program and we’ve performed over 100 outpatient total joint replacements with great success,” shares Dr. Stephen Snow, Medical Director of the Outpatient Surgery Center at Oly Ortho. The outpatient total joint replacement program, including hips and knees, was thoroughly planned prior to implementation and has experienced a successful first year.
For some, it’s hard to imagine the complex surgery, with prior hospital stays of up to a week, as an outpatient procedure. “It’s a bit of a paradigm shift,” Dr. Snow admits. “These bigger surgeries can be safely done in an outpatient setting with very high patient safety and patient satisfaction.” A few key advancements have made this possible including advanced pain control options including regional nerve blocks, numbing only the surgical region instead of the entire limb, and local, infiltrating anesthetics delivered to the surgical sites.
Post-op, patients must demonstrate mobility and get the “OK” from a physical therapist before they can be released. These new pain options allow that to happen within hours. “Now people can get physical therapy (PT) right out of the recovery room,” shares Dr. Snow. “They can get right up and start walking instead of waiting a day or more for muscle function to return.”
“We’ve found that if people expect to stay for three days in the hospital, they stay for three days. If they expect to go home that day, they are disappointed if they can’t,” says Dr. Snow. “By preparing them and their expectations in advance, patients are much more likely to successfully follow their post-surgical plans.”
Patients must be prepared for surgery, both mentally and physically, to ensure success. Surgery Center Director Sylvia Johns and Nurse Navigator Becki Taylor are essential in this preparation. The first step is to determine if a patient is a good candidate for the outpatient program.
“We have selection criteria that we use to see if the patient is right for our program,” explains Taylor. “First, the patient has to be motivated and have good family support at home. Second, they have to be healthy – meaning they can’t be significantly overweight, have any underlying heart conditions or other critical medical issues.” Often, patients are not good candidates for the outpatient program. In these cases, Oly Ortho works in concert with their hospital partners at Capital Medical Center and Providence St. Peter Hospital to facilitate a smooth inpatient plan is implemented.
For those who qualify, the next step is an outpatient joint replacement class including information needed for pre- and post-operative care. A pre-operative physical therapy session is next, ensuring the home environment is prepared for a successful return home. “We give them all this information proactively so that they can be successful and are able to go home that same day,” Taylor says.
With an outpatient procedure, walkers and other home equipment, prescription medications, and PT appointments are pre-arranged. “Everything is set up in advance so the transition from here to home is seamless,” says Taylor.
Taylor herself is one of the most valuable assets to the program. She is in contact with patients by phone or email whenever needed and does personal follow up calls one day and one week after surgery. “Becki’s role is key to our success,” says Sylvia Johns. “What she does is a bit like a concierge service that she provides to the patients so they know they can reach someone directly with any questions. Becki really prepares them from beginning to end which has influenced patients to be very motivated.”
Dr. Snow is excited for the second year of the program, looking forward to serving more patients. He also notes both local hospitals offer outpatient joint replacement as an option and despite this new offering, 80% of total joint replacement surgeries are still performed as inpatient procedures.
Leading the region in this national trend, Olympia Orthopaedic Associates looks forward to answering your questions about if outpatient total joint surgery is right for you or a family member. “We are really here to serve our community – that’s what we’re all about,” says Dr. Snow. “With all the options we have locally, you really don’t need to go farther than Olympia for a joint replacement surgery.”
Learn more about Olympia Orthopaedic Associates online or call 360-709-6230.