In the face of an increasingly complex global pandemic and constantly evolving healthcare cost structures, one thing has become abundantly clear for orthopedic surgeons in the United States: total joint replacement procedures can be performed effectively in the Ambulatory Surgery Center (ASC), and in some cases, it may even be a better setting for them.
While the transition to ASCs was already underway prior to 2020, the stresses COVID 19 inflicted on the healthcare system virtually eliminated many hospitals’ capacity for these elective procedures. This forced many orthopedic surgeons to adapt quickly and turn to these outpatient settings. As they gained more comfort and confidence performing total joint arthroplasty (TJAs) in this space, the trend continued to accelerate and was compounded by changing reimbursement structures. From the elimination of procedural codes off the CMS in-patient only list, to bundled payments and patient preference (due to lower risk of infection and outcomes that are equitable to when those procedures are done in a hospital), more driving forces point to TJA finding a permanent home in the ASC than ever before. Estimates suggest that by 2028, 53% of all total joint arthroplasty procedures in the U.S. will be performed in outpatient settings. This is a projected growth of 712% - 1105%.1 Such a significant shift demonstrates widespread acceptance—but it does not come without some risk factors. At the end of the day, healthcare providers are still responsible for finding ways to protect patients and get them back to their daily routine quickly.
How 3M™ Prevena™ Therapy Can Help Support the ASC
In general, total hip arthroplasty (THA) and total knee arthroplasty (TKA) are very successful operations.2 Unfortunately, complications (e.g., surgical site infections [SSI], seromas and dehiscence) can and do occur. These complications have been extensively studied and many risk factors have been identified including obesity, smoking and diabetes.3 For orthopedic surgeons looking for solutions to help reduce the risk of these challenges within the context of an ASC surgical environment, one such tool should be considered: 3M™ Prevena™ Therapy. Prevena Therapy can help decrease the risk of postoperative complications—both for these specific patient populations as well as more general ones too. Published clinical studies support the use of Prevena Therapy after TJA surgery to reduce postoperative complications.4-6
The benefits of introducing Prevena Therapy into TJA surgery practices go beyond just incision management. It can help providers deliver optimal surgical care—even in situations in which optimizing the patient before surgery simply isn’t feasible. Many orthopedic surgeons are now using Prevena Therapy in their primary hip and knee replacement patients in selective, higher risk clinical situations and have observed clinical improvements as a result.7
Three key reasons they turn to Prevena Therapy include that it helps:
- Protect the outcomes of incisions outside of the OR. It can help to hold incision edges together, remove fluids and infectious materials, reduce edema and mechanically support incisions for seven days.
- Reduce the risk of infection as the only negative pressure wound therapy device indicated by the FDA to help reduce superficial surgical site infections, in high-risk patients and seroma.*
*The effectiveness of Prevena Therapy in reducing the incidence of SSIs and seroma in all surgical procedures and populations has not been demonstrated. See full indications for use and limitations at myKCI.com.
- Enable at-home healing and low touch care, enhancing the postoperative rehabilitation process with a portable design, minimal dressing changes and flexibility for therapy discontinuation at home.
With a solution that can do all of this, orthopedic surgeons have a helpful tool for taking on these more complex procedures—and potentially taking on more of them as their confidence in performing them in the ASC care setting continues to grow. A higher volume of patients being efficiently and effectively treated with optimal surgical care in the ASC could mean realizing compounded cost reductions for TJA surgery—and that’s great news for everyone.
If you’re interested in learning more about the use of 3M™ Prevena™ Therapy in the ASC—including an insightful analysis from an orthopedic surgeon, documentation of the benefits and clinical evidence, a representative case and more—please download our new whitepaper: Use of 3M™ Prevena™ Therapy for Total Joint Arthroplasty Incisions in the Ambulatory Surgical Center.
1. Procedure Sites of the Future: Transitions and Growth Across HOPDs, ASCs. Skokie, IL 2019
2. Rutherford RW, Jennings JM, Dennis DA. Enhancing Recovery After Total Knee Arthroplasty. Orthop Clin North
3. Alamanda VK, Springer BD. The prevention of infection: 12 modifiable risk factors. Bone Joint J. 2019;101 B(1_Supple_A):3-9. Am. 2017;48(4):391-400.
4. Cooper HJ, Bas MA. Closed-Incision Negative-Pressure Therapy Versus Antimicrobial Dressings After Revision Hip and Knee Surgery: A Comparative Study. J Arthro. 2016;31(5):1047-1052.
5. Pachowsky M, Gusinde J, Klein A, et al. Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty. Inter Ortho. 2012;36(4):719-722.
6. Higuera-Rueda C, Emara AK, Nieves-Malloure Y, et al. The Effectiveness of Closed Incision Negative Pressure Therapy versus Silver-Impregnated Dressings in Mitigating Surgical Site Complications in High-Risk Patients after Revision Knee Arthroplasty: The PROMISES Randomized Controlled Trial. J Arthro. 2021;36(7S):S295-S302.
7. Anatone AJ, Shah RP, Jennings EL, Geller JA, Cooper HJ. A risk-stratification algorithm to reduce superficial surgical site complications in primary hip and knee arthroplasty. Arthro Today. 2018;4(4):493-498.