Abstract
Recent advancements in arthroplasty surgical techniques and perioperative protocols have reduced the duration of hospitalization and length of recovery, allowing surgeons to perform joint replacement as an outpatient procedure. This study aims to evaluate the cost-effectiveness and safety of outpatient hip resurfacing. Two experienced surgeons performed 485 resurfacing surgeries. We retrospectively compared clinical outcomes and patient satisfaction with published outpatient total hip results. Furthermore, we compared average insurance reimbursement with that of local inpatient hip replacement. No major complications occurred within 6 weeks. Of the 39 patients with previous inpatient experience, 37 (95%) believed their outpatient experience was superior. The average reimbursement for hip arthroplasty at local hospitals was $50,000, while the average payment for outpatient resurfacing at our surgery center was $26,000. We conclude that outpatient hip resurfacing can be accomplished safely, with high patient satisfaction, and at a tremendous financial savings to the insurer/patient.Level of evidenceIII
Highlights
Joint replacement has entered an era of greater minimally invasive alternatives, which provide patients with options to decrease recovery time and financial expense
Several centers have shown that total hip arthroplasty (THA) can be performed safely and cost effectively as an outpatient procedure [1, 3,4,5], there have been no reports on outpatient hip resurfacing arthroplasty (HRA), to our knowledge
Many factors could be responsible for the lack of published outpatient outcomes on HRA, including that resurfacing often requires a longer learning curve [6,7,8], sometimes requires longer operative times, and results in greater rates of failure when performed by less-experienced resurfacing surgeons [9]
Summary
Joint replacement has entered an era of greater minimally invasive alternatives, which provide patients with options to decrease recovery time and financial expense. The three major cost drivers of joint replacement surgery include the price of the implant, extraneous hospital fees, and postoperative rehabilitation expenses [1]. With recent advancements in analgesia technology, implant design, surgical technique, and postoperative management [2], many practices offer outpatient surgery as an alternative to decrease healthcare costs and expedite patient recovery [1]. Many factors could be responsible for the lack of published outpatient outcomes on HRA, including that resurfacing often requires a longer learning curve [6,7,8], sometimes requires longer operative times, and results in greater rates of failure when performed by less-experienced resurfacing surgeons [9]
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