What happens when advances in smaller-incision orthopedic surgery and ultrasound-guided regional anesthesia techniques converge in an ambulatory surgical center? When the facility’s surgeons aren’t afraid to ask, “Why not?” the result is an innovative new program that could be a game-changer in health care: same-day joint replacement surgery in an ASC.
Putting protocols in Place
About a year ago, the 8 surgeon-partners at Advanced Center for Surgery in Altoona, PA., began writing highly specific, formal protocols for every aspect of joint replacement surgery (knees, hips, shoulders, and ankles). They knew there was a group of relatively young, healthy people who wanted new hips or knees, but didn’t necessarily need or want to stay in a hospital. The surgeons hand-picked a team of professionals — nursing staff, anesthesia provider, home nursing care — to support their program, and by December 2012, they had scheduled their first case. To date, they’ve replaced 25 knees (total and unicompartmental arthroplasties), 2 hips and 1 shoulder. Patients undergoing surgeries that traditionally require 2, 3 or more days in a hospital are leaving this surgery center, smiling and pain-free, in less than 4 hours.