Advances in Same-Day Joint Replacement and Spine Surgery

Article originally posted on NJ.com – Advances in same-day joint replacement and minimally invasive spine surgery

University Center for Ambulatory Surgery (UCAS) is a freestanding outpatient surgery center located in Somerset. UCAS specializes in orthopaedic surgery with a unique focus on same-day (or outpatient) joint replacement and minimally invasive spine surgeries. The experienced and innovative surgeons at UCAS, along with a team of nationally recognized anesthesiologists who specialize in pain management, can perform these procedures and have the patient go home the same day. This eliminates overnight hospital stays and inpatient rehabilitation. Dr. Jeffrey Bechler, orthopaedic surgeon at University Orthopaedic Associates and orthopaedic director of UCAS, discusses some of the recent advances and patient benefits of same-day joint replacement and minimally invasive spine surgery.

Q: What are some of the outpatient procedures currently performed at UCAS that typically are performed in a hospital?
A: Over the last two years, we have been performing joint replacement procedures on an outpatient basis that include total hip replacement, total knee replacement and partial knee replacement. These procedures typically require about a two- to three-day hospital stay, but our patients are able to go home the same day. Additionally, spinal conditions, such as cervical and lumbar herniated discs, degenerative disc disease and spinal stenosis, can be treated using minimally invasive surgical techniques, which also allow the patient to recover at home.

Q: What are some of the medical advances or factors that enable you to do these procedures in an outpatient setting?
A: From a surgical standpoint, our emphasis is on minimally invasive surgical techniques. The less invasive the surgical technique, the less pain the patient experiences, the faster the surgical area can heal and the quicker the patient can return to daily life. For example, during a hip replacement surgery, our surgeons specialize in minimally invasive anterior hip replacement where the surgeon makes an incision in the front of the hip instead of the back or the side, which minimizes the amount of muscles and tendons that are disturbed around the hip joint during the surgery. These patients have less pain and a faster recovery time. Additionally, patient selection is a key factor to ensure a successful outcome. The patients are prescreened by the surgeon and medical physicians, as they need to be medically healthy and motivated to be able to recover at home after having their surgery as an outpatient.

Q: How does anesthesia and pain control play a role in same-day surgery?
A: Our anesthesiologists at UCAS are at the cutting edge of the most advanced and safest anesthesia techniques. This includes the use of advanced regional anesthesia techniques, peripheral nerve blocks and the placement of indwelling catheters that allow the regional pain anesthetic to be effective for two to five days following the procedure. Previously, total joint replacement and spine surgery were performed in hospitals because of patients’ need for post-surgical pain relief. Using these advanced anesthesia techniques allows the patients to undergo the same orthopaedic procedure, but affords them the opportunity to recover in the comfort of their home with the regional pain block continuing for several days.

Q: What are some of the benefits to patients of having outpatient minimally invasive spine surgery and total joint implant surgery?
A: Patients who qualify to undergo same-day outpatient total joint replacement and minimally invasive spine surgery can recover in the comfort of their own home and obviously avoid having the inconvenience of staying several nights in the hospital. Most importantly, they are not exposed to the hospital risks that can accompany inpatient admissions. There is no admission to an inpatient rehabilitation facility, as the patient can have rehabilitation in his or her home and then make the transition to an outpatient physical therapy center to complete the recovery process.