More and more, younger people are presenting to us with advanced arthritis. More and more, older patients continue to remain very active and even play competitive sports. Many of today’s joint replacement patients are otherwise healthy and motivated to return to an active lifestyle.
Traditionally, joint replacement of the hip, knee or shoulder has been associated with an overnight stay in the hospital lasting 1-3 days. The main purpose of this overnight was to ensure adequate pain control and safe mobility. Modern pain management techniques, including regional nerve blocks, long-active local anesthetics and multi-modal, opioid-sparing medication regimens have revolutionized recovery from joint replacement. Combined with less-invasive, tissue-sparing technique, patients recover faster and can mobilize immediately.
These advancements render an overnight in the hospital no longer necessary for many patients. As such, younger patients with commercial insurance can undergo surgery at an Ambulatory Surgery Center (ASC). These are free-standing centers that are highly focused on surgical care and avoid the drawbacks of the hospital (sicker patients, more virulent bacteria, inefficient, etc…). Modern surgery centers have been designed for outpatient joint replacement, making the experience not only safe but also much nicer for patients and family.
As of now, Medicare patients may undergo outpatient surgery, but it must be done in the outpatient department of a hospital. Medicare is currently reviewing safety and cost data on this matter and we expect that as of 2020, total knee replacements will be allowed to transition to ASCs for Medicare beneficiaries.
The benefits of outpatient joint replacement are many and our patients who return home the same day experience high levels of patient satisfaction in the process compared to hospital-based care. At home, people can manage pain and mobility in real time and do not have to wait for the nursing or therapy staff. The food is better, the bed is more comfortable and the setting is familiar. These things make the process of recovery much more pleasant than being in an unfamiliar setting with machines beeping and people coming in at all hours.
Our practice has established a comprehensive outpatient joint replacement program called AVATAR. We have performed more outpatient joints than any other practice in New England. Like most things in life, experience makes a difference. Surgery is a complex process that requires management and coordination. Our program provides concierge level service, customized care programs, the best implants and surgical techniques and selected ancillary care providers.
AVATAR is defined as the embodiment of a philosophy. For us, this means getting patients back to the person they want to be. It is an acronym that stands for Alignment of Vital Assets to Accelerate Recovery and it works. If you need a hip, knee or shoulder replacement, put our program to work for you and become your AVATAR.