Cutting-edge outpatient total joint replacement program helps Coastal Orthopedics patients heal faster

Physicians at Coastal Orthopedics Sports Medicine and Pain Management (CoastalOrthopedics.com) are breaking new medical ground by providing outpatient hip and knee replacement procedures that help their patients heal more quickly in the peace and quiet of their own homes, while also reducing medical costs.

Embracing the new outpatient total hip and total knee procedures places Coastal Orthopedics’ joint replacement specialists Drs. Alan L. Valadie and David V. Cashen on the cutting edge of joint replacement medicine around the world.

More than 1 million Americans undergo joint replacement procedures each year, a number expected to climb to almost 4 million by the year 2030. The nation’s aging Baby Boomer population, as well as a trend that sees Americans undergoing joint replacement procedures at a younger age, drives that projected increase.

Until recently, patients undergoing hip or knee replacements would be universally required to have the procedure performed in a hospital, but innovative physicians like those at Coastal Orthopedics began wondering if a costly hospital stay was really necessary for safe and successful surgery. Drs. Valadie and Cashen encountered many patients, mostly younger than average, who didn’t need an extensive hospital stay to recover.

“We’re always trying to get better; we’re always trying to push the limits,” says Dr. Valadie. “And so we started wondering: Do all our patients really need to go to the hospital?”

Joining the ranks of some of the most advanced joint replacement surgeons in the country, Coastal Orthopedics’ physicians performed their first outpatient partial knee replacement two years ago, followed by their first outpatient total knee replacement six months ago. They performed their first outpatient total hip replacement one year ago.

The procedures have been made possible by advances that make the surgeries as minimally invasive as possible, as well as sophisticated pain management techniques such as nerve blocks installed with ultrasound guidance and longer-lasting local anesthetics. By choosing the surgery center route, patients avoid long, expensive hospital stays that increase the risk of serious infections.

Bradenton’s Kris Pepper, 62, underwent a total hip replacement with Dr. Valadie on the morning of March 13. By that afternoon, with the aid of a walker, she was able to walk and travel home to recover. Dr. Valadie ensured the procedure would be as minimally invasive as possible by entering the hip through Pepper’s anterior leg muscles, rather than the posterior. Pepper says she never experienced much pain in the hip itself, but that she felt some bruising in the muscles around the 3.5-inch incision. Within three and a half weeks, she was back at work.

“My surgery was at 8 in the morning and I was home by 1 in the afternoon,” Pepper says. “With the traditional procedure, I would have had to stay in the hospital for a couple days.”

Working with an in-home physical therapist, and with the support of her sister, Pepper has already gotten back to the physical lifestyle she enjoyed before beginning to experience severe hip pain about a year ago.

“I’m walking the Riverwalk, riding my bike and doing in-home exercises,” Pepper says. “People are amazed.”

Dr. Valadie emphasizes that outpatient procedures aren’t for everyone. Ideal candidates are patients younger than 65 who are at a healthy, normal body weight and without complicating factors. They also need accommodating home designs and the support of educated family members.

Drs. Valadie and Cashen each perform more than 500 hip and knee replacements every year. While the percentage of those procedures that take place in an outpatient setting is still less than 10 percent, that number is growing.

One challenge to expanding the use of the procedure has been the slowness of insurance companies to support the shift toward the outpatient model. Valadie says the procedure is so new that insurers simply haven’t caught up to the latest trends in medicine. Ultimately, with the eventual full support of insurance companies, he thinks as much as 30 - 40 percent of the joint replacement procedures at Coastal Orthopedics could be done in an outpatient setting.

“Studies have shown that outpatient joint replacements result in average savings of $8,000, and overall the number of outpatient surgeries being performed is surging in comparison to inpatient procedures,” says Dr. Valadie. “Outpatient joint replacements are the way of the future. At Coastal Orthopedics, the future has already arrived.”

In addition to total hip and total knee replacements, Coastal Orthopedics surgeons also perform total shoulder replacement and total ankle replacement in the outpatient setting.

About Coastal Orthopedics Sports Medicine & Pain Management

Founded in 1973 and based in Bradenton, Florida, Coastal Orthopedics is home to 16 orthopedic surgeons and pain management physicians who maintain hospital affiliations with Blake Medical Center, Manatee Memorial Hospital and Lakewood Ranch Medical Center. In addition to three offices and two surgery centers each serving Florida’s West Coast, Coastal Orthopedics’ board-certified and fellowship-trained physicians and surgeons provide patients with the very latest in pain and orthopedic treatment technology. The company strives to repair and heal injuries relating to the entire musculoskeletal system. For more than 40 years, our highly skilled staff of physicians and surgeons have treated patients in specialty care including sports medicine, joint replacement, pain management and rehabilitation. Patients can experience restoration of function both surgically and non-surgically through the use of physician-guided strengthening, therapy, medications, injections and stretching. For more information, visit CoastalOrthopedics.com or call 941-792-1404.