Three orthopedic surgeon viewpoints on total joint replacements in ASCs:
1. Anthony Miniaci, MD, staff physician at the Cleveland Clinic's Center for Sports Health:
"Partial knee replacements over the years have expanded, especially when treating younger patients where we're trying to prolong their abilities to do their normal activities without replacing their full joints. Some of these concepts of partial replacements for joint problems are going to expand as we go forward. Also, for shoulder replacements, by restoring the patient's own functional anatomy, we've seen better results than the standard total shoulder replacements that we've been doing for years."
2. Frank J. Pompo, MD, an orthopedic surgeon at the Litchfield Hills Surgery Center in Torrington, Conn.:
"There has been significant growth in outpatient orthopedics over the past couple of years, including transitioning total joint replacement from the inpatient to the outpatient setting. When I was a resident, a patient who had an anterior cervical discectomy and fusion would stay in the hospital one to two nights. Now, it is an outpatient procedure. Total knee replacements, which were commonly three- to four-night inpatient status as recently as 10 years ago, now commonly only stay one night in the hospital or are now performed in the surgery center. While I think there will always be a role for elective surgery being done in the inpatient setting, we will see a greater percentage of orthopedic surgery being done in the outpatient setting."
3. Louis Levitt, MD, vice president and secretary of the Centers for Advanced Orthopaedics in Bethesda, Md.:
"We have learned that performing surgery in the outpatient setting is an exceptional model of care for the right patient. Patients can mobilize faster, return to the workforce sooner and they are regularly quite pleased with the outcomes. We should be incentivizing surgeons to perform these surgeries outside of the hospital when appropriate so the patient can enjoy a decreased risk of infection, more convenient care and a quicker return home."