How alignment technology can help ASCs prepare for incoming partial knee procedures

With about 50 percent of joint replacements, including partial and total joints, predicted to be conducted in an outpatient setting in the next 10 years, ASC leaders can expect to see more patients seeking partial knee replacements. To improve patient outcomes and surgeon satisfaction with these procedures, ASCs can employ computer-assisted alignment technology that increases surgeons' precision and helps prevent patients from needing revision surgeries.

This article is sponsored by OrthAlign.

At Becker's ASC 25th Annual Meeting: The Business and Operations of ASCs in Chicago Oct. 19, Kevin Fricka, MD, surgeon at Arlington, Va.-based Anderson Orthopaedic Clinic, and Sridhar Durbhakula, MD, orthopedic surgeon at Ortho Bethesda (Md.), discussed the benefits of performing partial knees in ASCs and how computer-assisted technology can be a cost-efficient method to improve patient outcomes and surgeon confidence in these surgeries.  

The benefits of performing partial knees in outpatient settings

Partial knee replacements add value to surgery centers by benefiting both surgeons and patients. "When patients receive a partial knee replacement in an outpatient setting, they recover faster, and ASCs can provide a much better experience than hospitals. The surgery is attractive to patients because they can keep all their ligaments and walk the same day as the surgery," said Dr. Fricka.

Outpatient partial knee replacement recovery is also more convenient for patients because they can rest in a familiar environment, Dr. Fricka said. "Partial knee replacements are less therapy intensive. And now, with telemedicine services, the patient doesn't have to travel to physical therapy appointments after surgery — much of it can be done at home."

Additionally, since patients return home from the surgery center the same day, surgeons cut down on patient rounds and have time to complete more surgeries. "As surgeons, time is our biggest asset, so performing partial knees in surgery centers is advantageous because it allows us to cut down on patient rounds and do a more efficient job by getting that patient home sooner," Dr. Fricka said. 

How computer-assisted technology can be used to improve partial knee outcomes

As surgery centers prepare to complete more total joint procedures, ASCs can use computer-assisted alignment technology to maintain high-quality care, Dr. Durbhakula said.

With partial knee replacements, one of the main challenges surgeons face is getting alignment perfect when making a tibial cut, as malalignment can lead to revision surgery and increased pain for patients. "The whole premise for alignment is based on the tibial cut, so if a surgeon's tibial cut is off, the rest of the knee will be off," Dr. Durbhakula said.

OrthAlign offers UniAlign, a handheld, computer-assisted alignment device that can improve a surgeon's precision during partial knee replacements. The device registers the mechanical axis of the tibia, which allows surgeons to get the correct angle of the cut, Dr. Fricka explained. Additionally, the device does not affect surgeon workflows because it only takes about 10 seconds to register the tibia.

"Having a device that leads to accurate cuts every time will give your surgeons more confidence in what they're doing," Dr. Fricka added. "In a partial knee replacement, if we put too much plastic in and overcorrect it, patients will have worse outcomes, including increased pain and malalignment that wears out the plastic and requires a revision surgery."

Harnessing technology to reach the best possible patient outcomes

As surgeons continue to perform more partial knee replacements in outpatient settings, computer-assisted alignment technology can help surgeons build confidence by ensuring a precise and accurate cut every time. 

ASC leaders can introduce this technology to their centers as a cost-effective device that not only helps surgeons feel more confident in their work, but also ensures patients have a successful recovery. "If surgeons want to start performing partial knees but are unsure, this technology is something that can help instill that confidence in them," Dr. Fricka said. "Knowing the tibia is the most important cut in a partial knee replacement, this technology lets the surgeon perform the procedure knowing the tibia cut is correct the first time."  

Surgeons have one opportunity to get the cut right, and once they go back in, it's not the same, so it is critical for surgeons to get an accurate cut the first time, Dr. Durbhakula added. "Considering this, any technology that can help surgeons get accurate cuts can help ensure the best possible outcomes for patients," he said.

More articles on orthopedics and TJR:
3 key reasons total knee replacements are migrating to the ASC setting
AJRR publishes report on hip & knee arthroplasty outcomes, ASC participation dips — 5 takeaways
Cleveland Clinic: How surgical robots improve joint replacements

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