Outpatient Joint Replacement
Patients frequently ask what has changed lately in the world of hip and knee replacement surgery. They are usually referring to changes in the implants, or asking if the longevity of implants has improved. In reality, the biggest and most exciting change over the last 5 years in the field of hip and knee replacement surgery has been in the location of the surgery itself.
Since the advent of joint replacement in the 1970s, these procedures have traditionally been performed in hospitals. For many years, this was the only viable option. The surgeries originally took several hours to perform, and rehabilitation and pain management protocols were completely overlooked and given very little emphasis. A lot has changed since then.
Advances in Joint Replacement
There have been several advances over the years to improve patient outcomes with hip and knee replacements, which eventually led to the development of outpatient hip and knee replacements.
Shorter Hospital Stays
In the early 2000s, orthopedics began to focus more on patient satisfaction and the quality of the recovery experience. We found that patients could return home just 3 days after surgery. They did not have to stay in the hospital for 10 days to 2 weeks, and they could go directly to their home, rather than stay at a skilled nursing facility for weeks after discharge.
This was considered a huge leap forward. We then began to realize that how a patient experienced their recovery, particularly how well their pain was controlled and how quickly they began to move around, had a huge impact on their complete recovery and long-term satisfaction with their hip or knee replacement.
Improved Pain Management
We also made huge advancements in pain management during this time period. We realized as an industry that narcotic pain medication, while necessary to a degree during recovery, was not ideal as a sole pain management tool. The concept of multimodal pain management began to take hold.
We developed an amazing synergy between this new method of pain control, physical therapy, and patient participation after hip and knee replacement surgeries. People were waking up from surgery without severe pain and start moving around right away. They were not suffering from debilitating nausea, vomiting, and dizziness (very common previously). They could eat full meals within hours of surgery, and they did not need to be hooked up to IV poles or urinary catheters. Soon, patients were leaving the hospital routinely the morning after their surgeries.
Outpatient Hip & Knee Replacements
The next logical progression in this paradigm shift was to question why these procedures even had to be done in the hospital at all. We found that many patients could avoid staying even overnight at the hospital and recover from the comfort and security of their own homes.
We knew that for years, many orthopedic surgeries were done away from hospitals with great success—rotator cuff repairs, knee ligament repairs, most hand surgeries, and many types of fracture repair. When we moved hip and knee replacement procedures into outpatient surgery centers, we also had great outcomes. Moving these surgeries to outpatient surgery centers benefited the patients and the surgeons.
The benefits of outpatient joint replacement were clear:
- Avoiding a hospital stay - Hospitals are built to care for the sick. Hip and knee replacement patients are not sick. They are healthy people that need a skilled care team and excellent surgical facilities.
- Decreased risk of infection - Since patients are not staying in a hospital with sick people, their risk of infection decreases.
- Recovery in the comfort of your own home - Most patients feel more comfortable in their own homes. They can get up and move around, and have visitors whenever they’d like.
Learn more about the benefits of outpatient joint replacement in the video below:
Outpatient Joint Replacement with Dr. James Ballard
In 2014, Dr. Ballard performed the first outpatient hip replacement ever done in a surgery center in the Northwestern United States, and it was a huge success. This was followed by 100 other hip and knee replacement procedures.
Dr. Ballard and his team knew that this outpatient surgery model could apply to many surgical areas, including many spine surgeries and trauma procedures. However, they needed a facility built for this purpose and dedicated to these types of cases. Up to this point, surgery centers had been built to take care of smaller cases—none had the facilities we needed to fully apply this model.
This is when Oregon Surgical Institute in Beaverton, Oregon was born. We collected a group of 13 of Oregon's finest joint replacement, sports medicine, hand, spine, and trauma surgeons and built a first-of-its-kind, state-of-the-art facility. There is no other facility like it in the Western United States.
Learn more about outpatient joint replacements at Oregon Surgical Institute below:
Oregon Surgical Institute (OSI) opened in April of 2018 and became fully operational that summer. Hundreds of hip and knee replacement surgeries have been performed at the facility, along with spine, sports, hand and trauma cases.
Orthopedic surgery is moving, as it should, away from the limited and complex hospital environment and into the nimble and streamlined outpatient center world. Dr. Ballard, along with OSI, are leaders in that shift. Dr. Ballard is proud and excited to have been a founder of this outstanding institution, and to offer this location to his patients for their hip and knee replacement procedures.
At OSI, Dr. Ballard and his team take steps to prepare patients before surgery, and are with them every step of the way after surgery to prepare them to return home. Learn more about outpatient joint replacement with Dr. Ballard in the video below: