Patients Opt for Outpatient Joint Replacement

Since December 2013, more than 50% of the 400 hip and knee replacements Craig McAllister, M.D. has performed have been done on an outpatient basis. This is a rate that, according to McAllister, leads national trends and is greater than the 10-year forecast nationwide.

He told a reporter for Kirkland News that, “Patients are happier, and tend to recover better at home. And as outpatients, the overall cost of care is lower.”

Outpatient hip and knee replacement is made possible, McAllister indicated, by careful patient selection, by giving patients detailed instruction prior to their surgery, his multimodal pain management and minimally invasive surgical techniques.

One patient group is elderly and suffering from preexisting medical conditions. Many may not have the resources in their homes to care for them. Members of this group usually stay in the hospital for several days. The second patient group, however, consists of individuals who are active, who do not have other medical conditions and who have a good home support system.

”Each patient is evaluated on a set of criteria to determine their candidacy for the procedure, including age, existing medical conditions, medications and physical activity, ” McAllister explained.

Patients who qualify for the outpatient surgery participate in an intensive pre-operation program with McAllister. The program includes one-on-one patient education specific to that patient’s case and family members are included in the preparation. While this takes more of a physician’s time prior to the surgery, McAllister says that it eliminates many time-consuming issues that—without the preparation—can come up following surgery.

The outpatient knee and hip surgery is also made possible by McAllister’s multimodal pain management. He administers preemptive analgesics, which are medications administered to the patient prior to surgery to minimize discomfort after the procedure. “The numbing medicines last up to 72 hours, so our patients are comfortable right from the beginning, ” said McAllister.

Pain management continues at home with the use of non-narcotic pain medications, and a continuous passive motion machine that gradually moves the joint through a prescribed arc of motion for a proscribed period of time.