Get a New Hip, Walk Home That Day
New Technique Turns Hip Replacement Surgery Into Outpatient Procedure
WebMD News Archive
Go Home the Same Day continued...
At least 80% of those patients getting the Zimmer procedure left the hospital within 24 hours of their hip replacement surgery. In order to be discharged, patients must demonstrate an ability to walk and climb stairs by themselves or with crutches or a cane, and require less potent oral pain medication.
A second study, not yet published, on other patients studied since that first group indicates the outpatient rate is now approaching 90% or better, says Berger.
None of the patients studied in the published research had any complications or needed to be readmitted for additional surgery, meaning their artificial joint remained fully attached. With the traditional surgery, a small number of patients have these postoperative problems.
Berger says many of his patients require no medication for postoperative pain. And since their scars are smaller, they heal faster and lose less blood in surgery. -->
Two Incisions, Smaller Instruments
With traditional hip replacement surgery, a large incision cutting into tissue is needed for surgeons to see and maneuver the artificial hip joint into place. But with the new technique, the two small incisions allow the surgeon to view the bone area from two different angles, and the smaller instruments allow for maneuverability in the smaller space.
The new procedure also doesn't require surgeons to twist the leg as was traditionally done, so veins aren't "kinked" -- raising risk of a post-op blood clot, says Berger. "So far, not a single patient I operated on has developed a blood clot," he tells WebMD. "By comparison, 3 to 5 percent of those getting traditional hip replacement do."
Others are equally impressed with the Zimmer procedure, which is also being developed for knee replacement surgery.
"With the smaller instruments in the hands of specially trained surgeons, this offers numerous benefits to everyone," says Dana C. Mears, MD, PhD, of the University of Pittsburgh Medical Center. He also contributed to the newly published report and first conceived the concept of a two-incision surgical technique for hip replacement procedures about 10 years ago.
"The patient has a faster recovery and less pain, if any," Mears tells WebMD. "The hospital can release patients sooner. And since months of the rehabilitation process can cost $20,000 or more per patient, and many getting hip replacement surgery are on Medicare, by reducing that rehabilitation to days or eliminating it altogether, the health-care system can save billions of dollars a year."
Another first with the Zimmer procedure: X-rays are used during, rather than following, hip replacement surgery to ensure the artificial joint is properly aligned and installed.
While Berger and Mears are among the first surgeons to do the Zimmer procedure, it's now performed by some 300 orthopaedic surgeons in the U.S., who receive special training by Zimmer Inc. and must be specially licensed to use the smaller instruments.