Report analyzes joint replacement surgeries in Pa.
Two years ago, the number of patients who needed to be readmitted to Canonsburg Hospital within 30 days of undergoing a knee replacement surgery was “significantly higher than expected,” according to a health report released Wednesday.
However, the medical community changes rapidly, which is evidenced by the fact a Canonsburg Hospital surgeon is now “on the cusp” of offering outpatient joint replacement procedures.
The report by Pennsylvania Health Care Cost Containment Council analyzed statewide data in 2013, including the number of elective knee and hip replacement surgeries at hospitals, readmission rates and the average cost of the procedure and hospital stay. Knee and hip surgeries in Pennsylvania increased by 38.5 percent from 2004 to 2013.
Dr. Donald Ravasio, an orthopedic joint replacement specialist at Canonsburg Hospital, said the procedure improved “light years” in a short period of time.
“Initially, when I was in my residency (from 1998 to 2002), you could bank on patients being in the hospital and having surgery on Monday and being there through Friday, and that was the routine,” Ravasio said.
Now, the length of a post-operative stay is about three days at Canonsburg Hospital. But by late summer or early fall, that admission process could be eliminated altogether for patients who are healthy enough to qualify. Ravasio said they are working on developing an outpatient program, and the procedures would be offered at the Health and Wellness Pavilion in Peters Township.
Ravasio said medical advancements in anesthesia brought doctors closer to that goal. Better anesthesia “allows the patient to be almost completely pain-free for the first 48 to 72 hours after surgery,” Ravasio said.
In the near future, a patient could have a surgery in the morning and be home by noon. At that point, a health professional with Allegheny Health Network’s Diamond Care program would be waiting for the patient in their driveway.
“I’m very excited about this,” Ravasio said. “I have several patients already asking me about it.”
Ravasio said the health council’s report is helpful for analyzing trends over time, but does not paint a clear picture of current practices. According to the report, costs associated with a joint replacement procedure in 2013 ranged from $24,911 to $39,857 in Washington and Greene counties.
Monongahela Valley Hospital performed more than 250 knee and hip replacement surgeries in 2013, which is more than any other hospital in the two counties, according to the report. Conversely, Southwest Regional Medical Center performed the fewest with 28 operations.
Joy Eggleston, spokeswoman for Southwest Regional in Waynesburg, said the hospital utilizes a group of orthopedic surgeons from Advanced Surgical Hospital in Washington, but many of the surgeries are performed at the Washington facility.
On the other hand, Monongahela Valley Hospital has taken on significantly more joint replacement surgeries since 2013, according to Lorraine Damich, a registered nurse and coordinator of Orthopedic Institute Care.
Damich said the Orthopedic Institute at the hospital gained a reputation as a “destination center” for joint replacement procedures. She said patients traveled to the hospital from Ohio and Rochester.
The hospital offers the only group-oriented program of its kind in Southwestern Pennsylvania, Damich said. Before surgery, patients take pre-operative classes with staff and get to know their fellow patients. After surgery, the same groups engage in group therapy sessions, where they track their walking distance and may even inspire fellow patients to “step it up,” Damich said.
“It’s amazing to see these patients encourage each other,” said Damich, adding patients are encouraged to walk at least 2,500 feet before they leave the hospital. Patients are also invited to return for quarterly reunion lunches in order to share their experiences and offer comments for improvement.
She said most patients seek joint replacements when the pain from arthritis becomes too unbearable and they can no longer lead an active lifestyle.