There was time – not too long ago – when major surgery such as hip replacement required an extended period of time in the hospital for recuperation. This was seen as necessary in order to ensure the patient did not experience complications from the procedure. This hospitalization added stress to the patient experience and also increased the expense of the procedure.
To the delight of many patients undergoing hip replacement surgery, the days of post-operative hospitalization are becoming a part of medical history. The latest treatment trend involves allowing some patients to return home on the same day of their surgery and Texas Health Spine & Orthopedic Center is at the forefront of this innovative approach.

New York Hospital First to Offer Same-Day Release

According to a report on CBS News at most hospitals, “hip replacement patients can expect a one- to three-night hospital stay. Total hip replacement surgery is increasingly common, with more than 300,000 procedures done every year in the U.S. The surgery is meant to restore range of motion and help relieve arthritic pain. The procedure consists of removing the patient’s worn out ball and socket joint and inserting an artificial socket. On the femur side, a stem is inserted into the bone and a ball is on the tip of it.”

The network reported that NYU Langone Medical Center became the first academic medical center in New York City to implement a same-day hip replacement program, in 2015.

The Benefits and Challenges

kwame-enninDr. Kwame Ennin is an orthopedic surgeon and participating physician with the Texas Health Spine & Orthopedic Center referral program, who has performed many hip replacement procedures and, under the right circumstances, is a proponent of sending patients home on the same day of their surgery. In a recent interview, he explained the advantages and challenges of this approach to recuperation.

“Same day surgery affords the patients the opportunity to have their hip replaced, while benefitting from the fact that they are not spending a lot of time in the hospital,” Dr. Ennin said. “By allowing the patient to return home on the same day of surgery, there is a considerable cost-savings, not to mention enabling them to be more comfortable in their own home.

“While there is no ‘downside’ to this treatment approach, the patient must be healthy enough to qualify for this same-day release. Patients who have medical issues such as heart issues or who might be a little older might need more monitoring after the operation and these we would keep under observation in the hospital.”

The Patient’s State-of-Mind is Important

Planning, both pre-operative and post-operative, is an important part of enabling the patient to return home on the day of their surgery. Dr. Ennin explains.

“When contemplating this treatment, the patient needs to really ‘buy in’ to the process,” he said. “This requires a pretty savvy patient. For example, we have a regimented post-operative program that requires the patient to take their pain medications at specific times.

“As for pre-operative coordination of the home recuperation, we make sure the patient’s prescriptions are filled – at home – before the surgery occurs.”

Insurance Considerations

Insurance coverage for this same-day surgery varies, depending on the type of insurance the patient has. If the patient is covered under Medicare and decides to have the procedure at a surgery center rather than a hospital, the same-day surgery will not be covered. However, if the patient has private insurance, this same-day surgery and return home approach will be covered by the insurance.

“If a patient is having this procedure in a surgery center, private insurance will pay for it and Medicare will not,” Dr. Ennin noted. “However, if he is having this procedure in a hospital setting, all insurance will pay for this same-day approach.

The Procedures Have Become More Sophisticated

Advances in orthopedic surgery have allowed for this quicker – home-based – recovery.

“Surgeons have gotten better at managing soft tissue damage and blood loss resulting from hip-replacement surgery,” he said. “Plus, we have new ways of managing pain through combinations of medications, even before the operation occurs.

“This is called ‘multi-modal’ pain control and it involves our treating pain from several perspectives. The end result is a less post-operative pain for the patient.

Recovery is Quicker

“While there are no expansive studies to prove this, anecdotally I have found that the quicker a patient can get back to his or her environment after hip replacement surgery, the quicker they will recover,” Dr. Ennin noted. “Day-to-day life – getting up to get a glass of water, rather than waiting for someone to bring you a glass of water – is therapeutic. The patient is up, moving and getting stronger.

“It’s all about living life,” he concluded.

If you would like to listen to the complete interview with Dr. Kwame Ennin, just click on the podcast below.

If you would like to discuss your options for same-day hip replacement surgery with Dr. Ennin or another orthopedic surgeon, contact us.

*Physicians who are members of the referral program practice independently and are not employees or agents of THSOC.

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