Midwest Center for Joint Replacement, Midwest Specialty Surgery Center, Indianapolis, IN.
J Arthroplasty. 2018 Jun;33(6):1647-1648. doi: 10.1016/j.arth.2018.02.002. Epub 2018 Feb 9.
Perhaps, the most significant developments in joint arthroplasty in the past decade have been in the area of multimodal perioperative management reducing pain, nausea, and length of stay leading to outpatient arthroplasty.
Over a 2-year period, we performed 1230 arthroplasty cases including partial knee, total hip, total knee, and selected revision cases.
Patient satisfaction ranged from 98% to 100% great/good. Ninety-eight percent of patients were discharged the same day. There were no readmissions for pain control and an overall readmission rate of 2%.
The outpatient program centers on the patient needs, family engagement, essentials of home recovery, preoperative education, efficient surgery, and a surgeon-controlled environment with a highly standardized care. This is a distinct shift in today's health-care environment, which has seen the expansion of regulatory demands; focus on Electronic Health Record, and distractions from real discussions of demonstrated value creation. The future is bright for both ambulatory surgery center and hospital development of successful outpatient joint arthroplasty program for patients and surgeons alike.
或许，过去十年关节置换领域最重要的进展在于多模式围手术期管理，该管理可减轻疼痛、恶心和住院时间，从而实现门诊关节置换。
在两年期间，我们进行了 1230 例关节置换手术，包括部分膝关节置换、全髋关节置换、全膝关节置换和部分翻修手术。
患者满意度为 98%至 100%（很好/好）。98%的患者当天出院。无因疼痛控制而再次入院，总体再入院率为 2%。
门诊计划以患者需求为中心，让家属参与，关注家庭康复要点，进行术前教育，进行高效手术，并营造由外科医生控制的环境，提供高度标准化的护理。这是当今医疗保健环境的一个显著转变，该环境扩大了监管需求的范围；关注电子病历，并分散了对实际有价值的讨论。对于门诊手术中心和医院来说，为患者和外科医生发展成功的门诊关节置换计划的未来是光明的。
