Wednesday, February 13, 2013

Outpatient joint replacement, expedited recovery

I recently went to see Mark Hartzband talk in Red Bank about outpatient joint replacement in a surgery center. I missed the first half and he was so kind to send me the PowerPoint file. I don't think outpatient surgery for joint replacement is right for everyone, but in select cases it can be done successfully.

At CentraState, through our Joint Center, we have implement many advancements over the last few years to speed up the recovery process and shorten the hospital stay. We have been using a cocktail of peri-operative medications combined with spinal anesthesia, nerve blocks, intra-operative anesthetic injections, minimally invasive surgery, and a rapid recovery protocol. It seems that Dr, Hartzband is having success with Decadron IV given in the OR and that has been added to our protocol.

We have been using IV Ofirmev (acetaminophen) quite successfully at CentraState and we have been able to cut down on narcotic usage by eliminating the PCA. This has resulted in much fewer issues with post-op nausea and our patients are recovering faster. At this point most patients under 70 years old should be able to be discharged to home in 1-2 days after surgery.