Outpatient Joint Surgery Offers Benefits

Some hospitals are seeing outpatient joint replacement surgery as a growth opportunity. Kendal Gapinski, writing for Outpatient Surgery publication says that advanced anesthesia techniques and muscle-sparing procedures are driving the trend.

Gapinski quotes Richard Berger, M.D., a hip and knee reconstruction and replacement orthopedic surgeon at Midwest Orthopaedics at Rush in Chicago, Illinois, who said, “It’s taken more than a decade to get people interested. But over the past 2 to 3 years, the idea of outpatient total joints has really started to take off.” Berger was one of the first surgeons to perform a same-day joint replacement. He did his first about 14 years ago.

Berger points out that ambulatory surgery centers can offer freedom and accommodations to surgeons that they cannot always get at a hospital where they practice. “On the inpatient side, it’s becoming more and more cumbersome, and more and more restrictive on what you can and cannot do, ” Berger said. “This is a way to get control back into the surgeon’s hands.”

Robert Kohen, M.D., an orthopedic surgeon performing total joints at UnaSource Surgery Center in Troy, Michigan, says that patients, given a choice, would rather be at home. He has performed outpatient total joints for about a year. He notes that many young people are opting for the surgery and that they are “healthier than the traditional population.”

Medicare does not authorize payments for total joint replacements performed in an outpatient setting, according to Gapinski, but private insurers are taking note. Kohen says that his center can currently only offer total knees, due to insurance constraints. But he sees the tide turning and believes it will change over time. “We do it at such a lower cost than inpatient procedures at a hospital, ” he said.