More efficient anterior hip replacements: the role of orthopedic tables

in collaboration with Mizuho OSI - Print  |

Demand for total hip replacements is growing among both younger and older patients.

Primary hip replacements jumped 712 percent over a 10-year period and by 2028, 42 percent of hip replacements are projected to be performed in ASCs. Shifting the location of these procedures makes sense, since ASCs are typically more efficient and cost-effective than hospitals.

At Becker's 17th Annual Future of Spine + The Spine, Orthopedic and Pain Management-Driven ASC Conference in Chicago, Mizuho hosted a workshop focused on anterior hip replacements in the ASC setting. Based on his experience in this area, Edward J. Whelan III, MD, offered recommendations for transitioning these procedures seamlessly from hospitals to the ASC.

Leveraging processes and equipment to improve efficiency

Total hip replacements in the ASC must be identical to procedures performed in the hospital. "It's critical that surgeons have the same staffing, imaging and instruments in the ASC. They shouldn't have to compromise their procedures at all," said Dr. Whelan. Surgeons strive for accuracy and reproducible processes, and the ASC must be set up to help them achieve their goals.

Early on, people thought that anterior hip replacements required special prosthetics and retractors, but that's not the case. One piece of equipment that can dramatically improve the efficiency of anterior hip replacements is an orthopedic table, such as Mizuho's Hana table.

"With the Hana table, I only need one assistant, rather than two. That's a savings of around $50,000 per year," explained Dr. Whelan. Since orthopedic tables are equipment, they also qualify as a tax write-off.

The table also offers other workflow efficiencies because ASCs can run two operating rooms with one Hana table. After finishing a procedure on one patient, the team can clean the table and move it to the second operating room where the next patient has received a spinal and is waiting for surgery. "If you have busy surgeons who want to do several total hips in one day, they don't have to wait for an operating room to be cleaned," said Dr. Whelan.

The table makes it easy for surgeons to move the C-arm in and out, which is a big advantage in the operating room. With a Hana orthopedic table, the average time for Dr. Whelan to complete an anterior hip replacement is 42 minutes.

Orthopedic tables are a natural fit for ASCs

Investing in an orthopedic table is a sensible move for ASCs and most surgeons today are trained to use orthopedic tables. As a result, ASCs with this equipment may have an easier time recruiting new talent.

"Nothing does the traction for a hip arthroscopy better than an orthopedic table," said Dr. Whelan. Beyond anterior hip replacement and arthroscopy, orthopedic tables include poly exchange, non-acute slipped capital femoral epiphysis, hip screw exchange, nail removal and tibial nailing.

From an administrative perspective, orthopedic tables are mobile and easy to store. Staff training can also be completed in half a day.


Performing anterior hip replacements represents a great opportunity for ASCs. Incorporating an orthopedic table into the procedures can be a gamechanger, streamlining operations and contributing to positive outcomes. As Dr. Whelan said, "Everyone likes total hip replacements in the ASC — insurance companies, doctors and patients. It's a no-lose if everything goes well."


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