Latest trends in outpatient orthopedics: 5 ASC industry experts weigh in

The breadth and acuity of outpatient orthopedic procedures has increased greatly with the advancement of technology and pain management procedures. Five ambulatory surgery center stakeholders discuss the latest trends in the field of outpatient orthopedics.

Question: What are some of the most exciting new trends in outpatient orthopedic procedures?

Joshua A. Siegel, MD, Director, Sports Medicine, Access Sports Medicine and Orthopaedics & Northeast Surgery Center of Newington, Exeter, N.H.: We are starting to see traditionally inpatient procedures such as total knee replacement and spine procedures migrating to ASCs. With the advances in anesthesia and home care services, the need to perform surgeries in hospitals is decreasing as many of these cases were done traditionally for close monitoring and pain control.
 
Other exciting trends include more biologic procedures using engineered tissues, and biologic replacements displacing some of traditional metallic implants used in the past.

Debbie Baker, MBA, CASC, LHRM, Chief Administrative Officer, Florida Orthopaedic Institute Surgery Center, Tampa: Orthopedics has changed so much over the last several years thanks to improved technology, less invasive techniques and cost efficiencies. We are seeing more and more procedures move to the outpatient setting such as total joints, spine and robotic-assisted procedures. More exciting is the level of satisfaction patients are reporting following their joint surgery in the surgery center due largely in part to pain control in joint replacements as well as being able to personalize each patient's care.

Jennifer Butterfield, MBA, RN, CNOR, CASC, Administrator, Lakes Surgery Center, West Bloomfield, Mich.: I'm most excited about the advancements in implant technology. There are a lot of innovative products available that have superior quality and are cost competitive. This is especially important to ASCs as many payers and Medicare do not reimburse for implants. In the past, my surgeons would trial an implant but say it wasn't better than what they were used to using. Now my surgeons are seeing products that are equal in quality but are less costly. Since these surgeons are very supportive of ASCs, they see this as a huge benefit to reducing costs in healthcare while providing high quality care.

Michael Chmell, MD, OrthoIllinois Surgery Center, Rockford: By far, the most amazing new trend in outpatient orthopedic surgery is the performance of total joint arthroplasties on an outpatient basis. If you had told me several years ago that in 2016 I would do a total knee replacement at 7 a.m., and the patient would be home before lunch, I would have thought you had lost your mind and had no clue about the procedure. Well, we have had great success doing total hips and knees at our center, with all going home the same day. The patients love it as they are at their home, eating their own food, sleeping in their own bed, and when I call them the evening after the surgery, they are watching their own television in their usual chair, with little to no pain issues. Of course, proper patient selection, planning and pain management is paramount. This, for now, is not for every patient. Who knows in the future, however, as my beliefs on outpatient procedures from past years have obviously been proved wrong.

Michael Thorpe, MD, Orthopedic Surgeon, Pacific Rim Outpatient Surgery Center in Bellingham, Wash.: Outpatient joint replacement is, in my opinion, the most exciting new trend in outpatient orthopedics!

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