Michael E. Berend
PARK CITY, Utah — Ongoing optimization of systems that classify patients for outpatient total joint arthroplasty and ensure these procedures are performed safely will lead to more outpatient TJAs being performed in the future, a presenter at the Joint Arthroplasty Mountain Meeting, said.
“I think the gateway to outpatient joint replacement, like anything you will hear at this meeting, ... is system optimization. We’ve been able to develop a program to eliminate the need for staying in a hospital, so we eliminate fear with preoperative education and prehab. I’m sure you’re all doing that to some degree. We identify and optimize appropriate patients and then we mitigate side effects with lower complications,” Michael E. Berend, MD, said.
More than 60% of cases performed by orthopedic surgeons at his practice are done same-day, he said, noting that includes unicompartmental knee arthroplasty, total knee arthroplasty and total hip arthroplasty. Some revision cases are also performed in the outpatient setting at his center, according to Berend’s abstract.
About 10 years ago, Berend and his colleagues helped develop and implement outpatient TJA centers for a group of physician-owned ASCs and, according to the abstract, they found what made the transition away from in-patient TJA possible was a program that centered on patients’ needs and engaged family members.
Having a surgeon-controlled environment was also key, as was preoperative education for patients.
“I think over the next 5 to 10 years, this is going to be the market shift. There is significant value creation for the entire system. The payers realize about 30% savings under an outpatient program as opposed to an institutional-based program,” Berend said.
“I would say the bigger winners in this are you all, the providers, and the patients who really enjoy recovering at home than being in an institution,” he said. – by Susan M. Rapp
Berend ME. Outpatient THA and TKA: A win-win for everyone. Presented at: Joint Arthroplasty Mountain Meeting; Feb. 10-13, 2019; Park City, Utah.
Disclosure: Berend reports he receives IP royalties and research support from Biomet, is a Knee Society and Operation Walk board or committee member, receives stock or stock options from Promapp and Reconstructive Innovations, and receives IP royalties and research support from Zimmer.