SVMC Orthopedics Launches Same-Day Joint Replacement Program
BENNINGTON, Vt. — Southwestern Vermont Medical Center Orthopedics launches the area's first Same-day joint replacement program.
Healthy patients in need of a hip or knee replacement can now work with their surgeon to determine if a same-day joint replacement would be right for them. Both same-day and traditional joint replacements can now be completed in as little as four weeks from the patient's first appointment.
"Same-day joint replacements started at the most elite medical institutions a few years ago and are slowly becoming more common," Michaela Schneiderbauer, medical director of Orthopedics at Southwestern Vermont Medical Center (SVMC). "We are proud to have created a formalized, evidence-based program and to make this procedure available here at SVMC."
Patients often opt for a joint replacement when other treatments fail to help the patient manage osteoarthritis pain. SVMC Orthopedics completes hip replacements using either the posterior or the anterior approach. The posterior approach is more traditional, while the anterior approach disrupts less of the patient's muscle tissue and can relate to faster recovery. Joint-replacement patients receiving a new hip or knee typically expect to stay in the hospital for three days after a procedure.
Advancements in surgery and anesthesiology, a better understanding of medical risks, and improved recovery data have shortened hospital stays and led surgeons to begin offering same-day joint replacements. The outcomes of same-day procedures show no greater risk of complications or readmissions for patients who qualify.
"When we saw the research that indicated good outcomes for low-risk patients and faster recoveries, we knew we wanted to make this procedure available to patients here," Schneiderbauer said.
All joint replacements involve medical professionals from many disciplines—including primary care, orthopedics, anesthesiology, post-anesthesia recovery, and physical and occupational therapy—to work as a team. Team members from each area were involved in developing SVMC's new same-day joint replacement program.
Surgeons work with patients closely to determine if they are a good candidate for the new procedure. Patients must be generally healthy, able to follow detailed instructions both before and after surgery and have a strong support network at home.
"Rehabilitation starts before the patient enters the hospital for their elective joint," Michaelia St. Jacques, an occupational therapist who helped develop the program said. "Patients attend a comprehensive joint replacement class, which allows them to meet their goals quicker starting immediately after surgery."
Anesthesiologists use nerve blocks at the surgical site, spinal blocks, and some sedation during the procedure, rather than a general anesthetic, as was used in the past. This change eliminates dizziness and nausea sometimes associated with general anesthesia. It also allows patients to be more alert after surgery and able to approach therapy sooner. Physical and occupational therapies start as soon as the patient can stand assisted.
"Patients are able to get themselves up and moving, get dressed and use the bathroom just hours after coming out of surgery," said St. Jacques.
Once the procedure, recovery, and initial therapy session are complete, patients are discharged home, if they are able to complete their functional mobility and activities of daily living with an assistive device.
Osteoarthritis is a very painful condition that limits patients' mobility and quality of life. The practice is pleased to get patients the help they need within a month of their first appointment.
Data suggests that many patients experience better outcomes and higher satisfaction with same-day surgery. The same-day procedure also saves healthcare costs compared to the inpatient surgery.
"Being at home is a comfort to many patients. They sleep better in their own beds," Schneiderbauer said. "While it's not the best option for everybody, we think same-day joint replacements will make a big positive difference for many of our patients."
In addition, to complete joint replacements, SVMC Orthopedics offers preventive and non-surgical treatments, minimally invasive surgery, and surgery for sports injuries, painful joints, rotator cuff repair, and complicated fractures.