QD 72 - Same Day Outpatient Hip Replacement Save
QD Clinic - Lessons from the clinic
Same Day Hip Replacement, PT and Discharge
Features Dr. Jack Cush
Transcription
This is QD Clinic. I'm doctor Jack Cush, RheumNow. QD Clinic is brought to you by RheumNow Live. Great rheumatologists like you go to great meetings like this. QD clinic is coming to you from RWCS in Maui where we discussed some cases yesterday.
I'm gonna give you one of them. February, a patient goes in for a hip replacement. You, the rheumatologist, get a letter from the orthopedist saying, guess what? The gentleman was treated with a spinal block and IV sedation. He had physical therapy immediately, post operatively.
He was sent home the same day on analgesic medicines and meds to prevent deep vein thrombosis. That's right. Same day outpatient hip replacement. We've heard about this at our meeting here several times. Heard a great lecture from Doctor.
William Bugbee, a great orthopedist from UCSD in San Diego, where this has become commonplace. He says outpatient surgery is being driven by number one, Medicare, two, economics, and three, entrepreneurialism. It's also being driven by new techniques, new anesthesia, and I think the idea that you can do a lot better, a lot faster. There's also some recent guidelines that are published in the CMAJ, the Canadian Medical Journal, about who basically shouldn't get these out same day outpatient procedures, largely being done on hips, often being done on knees. Who shouldn't get them?
Individuals over the age of 80. Those with a bleeding disorder, those who have chronic renal disease, greater than stage two CKD, those with liver disease, those who have sleep apnea that's severe, those who had recent cardiac events, diabetics, and those who are overly obese, morbidly obese. These are all non candidates for same day outpatient surgery. Otherwise, patients who are otherwise mentally able to consent and adapt and who have the support system in place for transportation and home care can go home the same day they have their hip or knee replacement. Things are changing in rheumatology.
That's it for QD clinic. Tune in tomorrow for another. I'm Jack Cush.
I'm gonna give you one of them. February, a patient goes in for a hip replacement. You, the rheumatologist, get a letter from the orthopedist saying, guess what? The gentleman was treated with a spinal block and IV sedation. He had physical therapy immediately, post operatively.
He was sent home the same day on analgesic medicines and meds to prevent deep vein thrombosis. That's right. Same day outpatient hip replacement. We've heard about this at our meeting here several times. Heard a great lecture from Doctor.
William Bugbee, a great orthopedist from UCSD in San Diego, where this has become commonplace. He says outpatient surgery is being driven by number one, Medicare, two, economics, and three, entrepreneurialism. It's also being driven by new techniques, new anesthesia, and I think the idea that you can do a lot better, a lot faster. There's also some recent guidelines that are published in the CMAJ, the Canadian Medical Journal, about who basically shouldn't get these out same day outpatient procedures, largely being done on hips, often being done on knees. Who shouldn't get them?
Individuals over the age of 80. Those with a bleeding disorder, those who have chronic renal disease, greater than stage two CKD, those with liver disease, those who have sleep apnea that's severe, those who had recent cardiac events, diabetics, and those who are overly obese, morbidly obese. These are all non candidates for same day outpatient surgery. Otherwise, patients who are otherwise mentally able to consent and adapt and who have the support system in place for transportation and home care can go home the same day they have their hip or knee replacement. Things are changing in rheumatology.
That's it for QD clinic. Tune in tomorrow for another. I'm Jack Cush.
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