Is Outpatient Joint Replacement An Option For You?

 

OUTPATIENT JOINT REPLACEMENT

GENERAL

If you are healthy enough, outpatient joint replacement (where you have surgery and go home on the same day) may be an option for you at EmergeOrtho.  In comparison to inpatient joint replacements, much of the process remains the same but there are a few differences.  Special consideration of the medical status of the patient is the biggest factor.  Anesthesia techniques (to make you more comfortable) are modified for outpatient replacement patients.  Physical therapy at home is begun the day after surgery.  Since you won’t be at the hospital where the surgical team can check on you, an earlier follow-up appointment is scheduled.  Lastly, you’ll need a caregiver or team of caregivers present with you to assist with walking, medications, and meals.

Some of the advantages to outpatient joint replacement include:

1) cost

2) convenience/comfort

3) fewer complications

Outpatient joint replacements often offer substantial cost savings since there is no hospital stay.  Also, they can be done at “surgery centers” which typically charge significantly lower fees than typical hospitals might.  Many patients are more comfortable being at home in a familiar environment while they recover.  Patients may be more likely to avoid complications since they are likely to move around the home more than they might at the hospital.  Lastly, the chance of picking up an infection from something or someone at the hospital is lessened the shorter the amount of time spent there.

Sometimes patients scheduled for outpatient surgery may end up having to stay at the hospital (or may be sent to a hospital from a surgery center) if unforeseen complications occur.  To lessen this risk, the patient’s health is carefully screened prior to surgery.   The bottom line is your safety is our top concern.

AT THE SURGERY CENTER

The main differences between inpatient and outpatient joint replacements at the surgery center involve the type of anesthesia used.  Outpatient patients often get a shorter-acting “block” or injection to allow them to move their legs sooner.  A long-acting “local anesthetic” to numb the tissue around the incision is frequently used to help provide comfort.  Special combinations of pain and nerve medications may be prescribed.  Generally, urinary catheters are not used for patients undergoing outpatient joint replacement.

Rather than being transferred to a hospital bed (also called “the floor”) after surgery, you will have physical therapy (PT) when recovered enough in the post-anesthesia care unit (PACU). When you have proven you can walk appropriately with PT and are felt to be safe to be sent home, you will be discharged. Patients undergoing outpatient joint replacements may stay in the PACU longer than inpatient replacement patients since they need to be fully recovered before being released.

 

RECOVERING AT HOME

  • Take your medications as directed in your discharge paperwork
  • Your leg muscles may be weak for the first day or so – make sure to wear any braces sent home with you and use your walker or crutches when you move around
    • Do not stop using braces until you are advised to do so by your therapist or surgical team
    • Try to drink plenty of fluids and eat a healthy diet – you need energy to heal
    • Follow the instructions for your dressings and showering given to you at the time of discharge

 

To learn about whether outpatient joint replacement surgery would be a good fit for you, visit www.triangleortho.com or call (919) 220-5255 to schedule an appointment with one of our surgeons.

 

Article By: William Silver, MD, Orthopaedic Surgeon, Medical Director, EmergeOrtho Triangle Division

EmergeOrtho at Physician Assistants in Orthopaedic Surgery Conference!

Kuremsky (1)

 

EmergeOrtho at Physician Assistants in Orthopaedic Surgery Conference!

 

This weekend Physician Assistants in Orthopaedic Surgery hosted Extremities in the Carolinas, a subspecialty conference for PA’s practicing in Orthopaedics.  Dr. Marshall Kuremsky was invited to speak on two topics, Compressive Neuropathies of the Upper Extremity, and Distal Biceps and Triceps Tears.

The conference took place in Charlotte, NC, the city where Dr. Kuremsky spent his Internship and Orthopaedic Surgery Residency, at Carolinas Medical Center (CMC).  In fact, he was introduced onstage by a Physician Assistant who had worked with him at CMC.  During his residency, at Carolinas Medical Center, Dr. Kuremsky was selected as a Chief Resident in Orthopaedic Surgery.  He went on to become the only orthopaedic surgeon in the state with double Board Certification in Hand Surgery and Sports Medicine, and with this expertise he addressed the group of 250 Physician Assistants on Saturday.

Dr. Kuremsky treats upper extremity injuries in all age groups, with clinical interests including wrist and elbow arthroscopic surgery, elbow replacement, elbow ligament (“Tommy John”) reconstruction, labral and rotator cuff shoulder repair, endoscopic carpal tunnel release, and wrist ligament reconstruction, in the Apex, Brier Creek, and Raleigh locations of EmergeOrtho.

As the official organization for PA’s practicing in orthopedics, Physician Assistants in Orthopaedic Surgery (PAOS) created this conference as an opportunity for surgeons and other experts to speak on the most requested topics in Orthopedics.  Dr. Kuremsky was one of twenty specialists sharing the latest techniques, current literature, and pearls of wisdom for PA’s practicing in orthopedics.

Sam Dyer, PA-C, has been a Physician Assistant with Triangle Orthopaedics, now EmergeOrtho, for almost 20 years, and runs the Orthopaedic Urgent Care in Chapel Hill.  Last year he was elected the President of PAOS, and in his tenure has been working to increase CME opportunities, including video, and building membership of PA’s and student PA’s.

Clifford Daub, PA-C, DC, and Jonathan Prentice, PA-C, also attended the conference.  Cliff specializes in the Spine and sees patients in Durham with Dr. David Musante.  Jonathan works with Dr. Ralph Liebelt seeing Hip, Knee, Spine, and General Orthopaedics patients at the Durham office of EmergeOrtho.

In the Triangle Divison of EmergeOrtho, over fifty Physician Assistants and Nurse Practitioners care for patients in Orthopaedics, Rehab Medicine, Bariatrics, and Bone Health.  They work closely with the physicians in clinic and in surgery.  The ten Orthopaedic Urgent Cares in the greater Triangle area are staffed by these providers, enabling patients to pay a specialist copay as a more efficient, less costly alternative to the ER.

According to the American Association of Physician Leadership, nationally there are 416 PA’s for every 1,000 Orthopedic Surgeons.  Physician Assistants and Nurse Practitioners are important providers in EmergeOrtho’s mission to deliver patient-centered care.

 

Drs. Aldridge and Wilson accepted into American Shoulder and Elbow Surgeons Association!

Dr. Mack Aldridge and Dr. Joe Wilson have been welcomed into the American Shoulder and Elbow Surgeons Association (ASES), the premier association comprised of shoulder and elbow surgeons.  ASES holds one closed meeting per year, and both surgeons were approved at this year’s meeting.

Copy of Congratulations (2) Dr. Aldridge is certified by the American Board of Orthopaedic Surgery and has received his certificate of added qualification (CAQ) in Hand Surgery.  Dr. Aldridge has a broad range of knowledge of orthopaedic problems with subspecialty training in the upper extremity (hand, wrist, elbow). His interests range from complex trauma, elbow replacements, upper extremity arthritis, brachial plexus injury and reconstruction to endoscopic carpal tunnel release, and Dupuytren’s, among others.  Dr. Aldridge sees patients in the Chapel Hill, Durham, and Southpoint offices of Triangle Orthopaedic Associates, P.A.

Dr. Wilson has been in practice since 2001, and he not only has a unique range of knowledge in General Orthopaedics, he has a true passion for what he does for his patients.  As a Flight Surgeon in the United States Navy, and as a key member of an F-18 Fighter Attack Squadron, he served aboard the aircraft carrier, the USS Constellation.  His specialized knowledge in advanced arthroscopic techniques of both the shoulder and knee allow him to assess the best possible surgical procedure for each injury.  Dr. Wilson sees patients in the Apex, Durham, and Raleigh offices of Triangle Orthopaedic Associates, P.A.

 

Join us in Welcoming Our Newest Orthopaedic Surgeon

Welcome_Freels

 

Please join us in welcoming Dr. Douglas Freels,MD, to our orthopaedic team!  He will be seeing patients at Wilson Ortho, a division of Triangle Orthopaedics.

Dr. Freels has extensive experience in orthopedic surgery and joint replacement patients having been in practice for over 18 years. This includes both primary hip, knee, and shoulder replacement patients including minimally-invasive joint replacement surgeries such as the “Oxford” partial knee replacement and the direct anterior approach for hip replacement surgery. He also has experience in the more complex joint replacement patients including infections, peri-prosthetic fractures, and revision joint replacement surgery.

To see Dr. Douglas Freels,MD, please contact us at 252-243-9629.