An 18-Year Experience with Outpatient Joint Replacement
After recently completing his 10,000th outpatient joint replacement, Richard A. Berger, MD, of Rush University Medical Center in Chicago, Illinois, can legitimately be called a pioneer of outpatient procedures.
Approximately 70% of his patients go home the same day as surgery. How did he get to this point? In a presentation at ICJR’s Winter Hip & Knee Course, Dr. Berger said it was a slow process that has involved understanding and refining how to get from surgery to recovery quickly and safely. Everything is interrelated: Minimizing soft tissue trauma during surgery means fewer perioperative medications to manage pain, which means fewer side effects like hypotension, nausea, and malaise. It also means fewer functional restrictions and easier rehabilitation.
All patients who go home the same day as surgery can only do so if they meet hospital-mandated milestones, Dr. Berger said, including the ability to:
- Transfer independently to and from the bed to standing and to and from the chair to standing
- Ambulate 100 feet without assistance
- Ascend and descend a full flight of stairs
Click the image above to watch Dr. Berger’s presentation and learn how he and his team developed a standardized protocol for outpatient joints and then adjusted it as they learned more about patient outcomes.
Dr. Berger has no disclosures relevant to this presentation.
More from the session Enhanced Recovery & Outpatient Arthroplasty at ICJR’s Winter Hip & Knee Course:
Selecting Patients for Outpatient Surgery: A Novel Scoring System, by R. Michael Meneghini, MD
Preoperative Medical Evaluation for Outpatient Total Joints, by David A. Kuppersmith MD
Outpatient Total Joints: It’s an Evolution, by Ashley Dentler PT, DPT, CMLDT, CSCS
Outpatient Joint Replacement Can Be a Big Mistake! by Gwo-Chin Lee MD