NYU Langone Medical Center has become the first academic medical center in New York City to initiate an outpatient hip replacement program! Roy I. Davidovitch, M.D., an assistant professor in the Department of Orthopaedic Surgery and Director of the Hip Center at NYU Langone, performed a minimally invasive anterior approach hip replacement in January; two additional patients have successfully undergone the surgery.
First Outpatient Hip Replacement in NYC
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“With advances in soft-tissue-sparing techniques such as the anterior approach and innovative pain management protocols, patients are able to recuperate in the comfort of their own homes, much like they do after outpatient arthroscopy procedures like an ACL reconstruction, ” said Dr. Davidovitch in the March 2, 2015 news release. “The goal of this new approach is to return patients to their normal level of activity as quickly as possible and minimize the discomfort of surgery.”
Dr. Davidovitch accesses the femur through a three-inch incision in the front of the hip joint. He does not have to cut muscles and tendon, meaning that postop pain is reduced. Because of this, patients can begin to move around right away.
According to the news release, “Surgery for patients who meet criteria for outpatient anterior approach total hip replacement usually is concluded by 9:00AM, giving them sufficient time to recover and mobilize in the hospital before walking out with an assist device by the early afternoon. A visiting nurse and physical therapist visit the patient at home the day after surgery, and intermittently over the following two weeks. Ultimately, the patient can be back to their normal activity level within six weeks.”
“Dr. Davidovitch’s outpatient hip replacement exemplifies our mission to bring patients the most recent treatment advances in orthopaedic surgery in an effort to improve their surgery outcomes and satisfaction, ” says Joseph Zuckerman, M.D., the Walter A.L. Thompson Professor of Orthopedic Surgery and Chair of the Department of Orthopaedic Surgery at NYU Langone Medical Center.
“I would not have been able to perform this surgical feat without the multidisciplinary care approach that underlies treatment at an academic medical center such as NYU Langone, ” Dr. Davidovitch says. “We worked together with anesthesiology, nursing, physical therapy, occupational therapy and social work to ensure this recent success, and we hope to emulate it and make it as much a part of our hip replacement program as possible.”
Dr. Davidovitch says the best candidates for outpatient hip replacement surgery are those who do not have cardiac disease and have a strong support network to aid in their at-home recovery
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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