Dr. Ritesh Shah's 7 necessities for the strongest outpatient total joint replacements

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Ritesh Shah, MD, chief of orthopedic surgery at Chicago-based Advocate Illinois Masonic Medical Center, said adopting new technology and having a multimodal pain pathway were among seven factors needed for the best outcomes in outpatient total joint replacements.

Note: Response was lightly edited for style and clarity.

Dr. Ritesh Shah: It has become almost a necessity for surgeons to do outpatient joint replacements for various reasons, including promising safety and quality data, patient preference, insurance preference, and COVID-19. Below are a few important principles that surgeons can use to be successful in outpatient joint replacements in 2021.

1. An objective algorithmic patient selection tool is very useful to minimize complications and readmissions. The Aria platform has been recently released to help guide surgeons adopting same-day joint replacements.

2. A methodical patient care pathway is needed to reduce gaps in patient care, promote a team approach to patient care, and result in a quicker recovery with greater patient satisfaction.

3. A reproducible multimodal pain pathway can reduce narcotic consumption and promote early mobility.

4. Surgeons should have blood-conservation and tissue-preserving techniques.

5. Surgeons should have a choice of implants and instruments that work well in an efficient and minimally invasive manner without sacrificing quality or longevity.

6. Adoption of new technology and digital care is the future specifically as it relates to surgical precision and efficiency and equally importantly patient care and outcome data analysis.

7. Surgeons should have a willingness to gain a thorough understanding of the whole process including preoperative, operative and postoperative care along with financials, sterilization, storage, staffing and outcome data analysis.

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