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Surgical Appropriateness for Outpatient TJA in an ASC

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Outpatient Hip and Knee Replacement

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Abstract

As total joint arthroplasty (TJA) transitions to the outpatient setting, more orthopedic surgeons are looking at the surgical appropriateness of performing these cases in an ambulatory surgery center (ASC). Performing TJAs at an ASC has multiple advantages including more personalized care, decreased cost to the healthcare system, better patient satisfaction, and lower risk of complications. Several studies have demonstrated the low complication rates and cost savings of TJA at an ASC, and this chapter will describe how to decide on the appropriateness of performing TJA at an ASC.

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References

  1. Berend ME, Lackey W, Carter J. Outpatient-focused joint arthroplasty is the future: the midwest center for joint replacement experience. J Arthroplasty. 2018;33(6):1647–8.

    Article  PubMed  Google Scholar 

  2. Berend ME, Berend KR, Lombardi AV Jr. Advances in pain management: game changers in knee arthroplasty. Bone Joint J. 2014;96-B(11 Supple A):7–9.

    Article  CAS  PubMed  Google Scholar 

  3. Berger RA, Sanders SA, Thill ES, et al. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop Relat Res. 2009;467(6):1424–30.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Krauss ES, Cronin M, Suratwala SJ, et al. Use of intravenous tranexamic acid improves early ambulation after total knee arthroplasty and anterior and posterior total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2017;46(5):E314–9.

    PubMed  Google Scholar 

  5. Berend KR, Lombardi AV Jr. Mallory TH: rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients. Surg Technol Int. 2004;13:239–47.

    PubMed  Google Scholar 

  6. Lombardi AV Jr, Viacava AJ, Berend KR. Rapid recovery protocols and minimally invasive surgery help achieve high knee flexion. Clin Orthop Relat Res. 2006;452:117–22.

    Article  PubMed  Google Scholar 

  7. Lombardi AV, Berend KR. Adams JB: a rapid recovery program: early home and pain free. Orthopedics. 2010;33(9):656.

    Article  PubMed  Google Scholar 

  8. Teeny SM, York SC, Benson C, Perdue ST. Does shortened length of hospital stay affect total knee arthroplasty rehabilitation outcomes? J Arthroplast. 2005;20(7 suppl 3):39–45.

    Article  Google Scholar 

  9. Cleary PD, Greenfield S, Mulley AG, et al. Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California. JAMA. 1991;266(1):73–9.

    Article  CAS  PubMed  Google Scholar 

  10. Kelly MP, Calkins TE, Culvern C, et al. Inpatient versus outpatient hip and knee arthroplasty: which has higher patient satisfaction? J Arthroplast. 2018;33(11):3402–6.

    Article  Google Scholar 

  11. Crawford DA, Adams JB, Berend KR, et al. Low complication rates in outpatient total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;28(5):1458–64. https://doi.org/10.1007/s00167-019-05538-8.

    Article  PubMed  Google Scholar 

  12. Giuliano KK, Baker D, Quinn B. The epidemiology of nonventilator hospital-acquired pneumonia in the United States. Am J Infect Control. 2018 Mar;46(3):322–7.

    Article  PubMed  Google Scholar 

  13. Greco NJ, Manocchio AG, Lombardi AV, et al. Should postoperative hemoglobin and potassium levels be checked routinely following blood-conserving primary total joint arthroplasty? Bone Joint J. 2019;101-B(1_Supple_A):25–31.

    Article  CAS  PubMed  Google Scholar 

  14. Tingle C, Berger RA, Bolognesi MP, et al. Same-day outpatient TJR gains popularity, but careful considerations must be made. Orthopedics Today. 2015;35(8):10–1.

    Google Scholar 

  15. Imran JB, Madni TD, Taveras LR, et al. Analysis of operating room efficiency between a hospital-owned ambulatory surgical center and hospital outpatient department. Am J Surg. 2019;218(5):809–12. https://doi.org/10.1016/j.amjsurg.2019.04.017.

    Article  PubMed  Google Scholar 

  16. Meneghini RM, Ziemba-Davis M, Ishmael MK, et al. Safe selection of outpatient joint arthroplasty patients with medical risk stratification: the "outpatient arthroplasty risk assessment score". J Arthroplast. 2017 Aug;32(8):2325–31.

    Article  Google Scholar 

  17. Berend KR, Lombardi AV, Berend ME, Adams JB, Morris MJ. Outpatient total hip arthroplasty: a paradigm change. JBJS. 2018;100-B(1 Supple A):31–5.

    CAS  Google Scholar 

  18. Meding JB, Klay M, Healy A, Ritter MA, Keating EM, Berend ME. The prescreening history and physical in elective total joint arthroplasty. J Arthroplast. 2007;22(6, suppl 2):21–3.

    Article  Google Scholar 

  19. Bozic KJ, Katz P, Cisternas M, et al. Hospital resource utilization for primary and revision total hip arthroplasty. J Bone Joint Surg Am. 2005 Mar;87(3):570–6.

    Article  PubMed  Google Scholar 

  20. Dowsey MM, Kilgour ML, Santamaria NM, et al. Clinical pathways in hip and knee arthroplasty: a prospective randomized controlled study. Med J Aust. 1999;170(2):59–62.

    Article  CAS  PubMed  Google Scholar 

  21. Kessels R. Patients memory for medical information. J R Soc Med. 2003;96(10):520.

    Google Scholar 

  22. Adelani MA, Barrack RL. Patient perceptions of the safety of outpatient total knee arthroplasty. J Arthroplast. 2019;34(3):462–4.

    Article  Google Scholar 

  23. Berend KR, Lombardi AV Jr. Liberal indications for minimally invasive oxford unicondylar arthroplasty provide rapid functional recovery and pain relief. Surg Technol Int. 2007;16:193–7.

    PubMed  Google Scholar 

  24. Mears DC, Mears SC, Chelly JE, Dai F, Vulakovich KL. THA with a minimally invasive technique, multi-modal anesthesia, and home rehabilitation: factors associated with early discharge? Clin Orthop Relat Res. 2009;467(6):1412–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Sculco PK, Pagnano MW. Perioperative solutions for rapid recovery joint arthroplasty: get ahead and stay ahead. J Arthroplast. 2015;30(4):518–20.

    Article  Google Scholar 

  26. Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL, et al. Clin Orthop Relat Res. 2010;468(1):135–40.

    Article  PubMed  Google Scholar 

  27. Jaeger P, Nielsen ZJ, Henningsen MH, Hilsted KL, Mathiesen O, Dahl JB. Adductor canal block versus femoral nerve block and quadriceps strength: a randomized, double-blind, placebo-controlled, crossover study in healthy volunteers. Anesthesiology. 2013;118(2):409–15.

    Article  CAS  PubMed  Google Scholar 

  28. Sankineani SR, Reddy ARC, Eachempati K, Jangle A, Reddy AV. Comparision of adductor canal block and IPACK block with adductor canal alone after total knee arthroplasty: a prospective control trial on pain and knee function in immediate postoperative period. Eur J Orthop Surg Traumatol. 2018;28:1391–5.

    Article  CAS  PubMed  Google Scholar 

  29. Johnson RL, Kopp SL, Burkle CM, et al. Neuraxial vs general anaesthesia for total hip and total knee arthroplasty: a systematic review of comparative- effectiveness research. Br J Anaesth. 2016;116:163–76.

    Article  CAS  PubMed  Google Scholar 

  30. MacFarlane AJR, Arun Prasad G, Chan VWS, Brull R. Does regional anesthesia improve outcome after total knee arthroplasty? Clin Orthop Relat Res. 2009;467:2379–402.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Lombardi AV Jr, Berend KR, Mallory TH, Dodds KL, Adams JB. Soft tissue and intra-articular injection of bupivacaine, epinephrine, and morphine has a beneficial effect after total knee arthroplasty. Clin Orthop Relat Res. 2004;428:125–30.

    Article  Google Scholar 

  32. Beaupre LA, Johnston DB, Dieleman S, Tsui B. Impact of a preemptive multimodal analgesia plus femoral nerve blockade protocol on rehabilitation, hospital length of stay, and postoperative analgesia after primary total knee arthroplasty: a controlled clinical pilot study. Sci World J. 2012;2012:273821.

    Article  Google Scholar 

  33. Lovald ST, Ong KL, Lau EC, Joshi GP, Kurtz SM, Malkani AL. Readmission and complications for catheter and injection femoral nerve block administration after total knee arthroplasty in the Medicare population. J Arthroplast. 2015;30(12):2076–81.

    Article  Google Scholar 

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Authors and Affiliations

  1. JIS Orthopedics, New Albany, OH, USA

    Jesua Law, David A. Crawford & Adolf V. Lombardi

Authors
  1. Jesua Law
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  2. David A. Crawford
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  3. Adolf V. Lombardi
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Correspondence to Jesua Law .

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Editors and Affiliations

  1. Department of Orthopedic Surgery, Indiana University School of Medicine, Indiana Joint Replacement Institute, Indianapolis, IN, USA

    R. Michael Meneghini

  2. Department of Orthopedic Surgery, Indiana University Health, Fishers, IN, USA

    Leonard T. Buller

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Law, J., Crawford, D.A., Lombardi, A.V. (2023). Surgical Appropriateness for Outpatient TJA in an ASC. In: Meneghini, R.M., Buller, L.T. (eds) Outpatient Hip and Knee Replacement. Springer, Cham. https://doi.org/10.1007/978-3-031-27037-6_3

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  • DOI: https://doi.org/10.1007/978-3-031-27037-6_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-27036-9

  • Online ISBN: 978-3-031-27037-6

  • eBook Packages: MedicineMedicine (R0)

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