Joint Replacement Surgery in the Time of COVID-19

For at least 7 weeks in New Hampshire, and for longer in many parts of the country, elective surgical procedures were cancelled to preserve hospital resources for the presumed surge in COVID patients. In certain states, such as New Hampshire, a surge with a peak never occurred. Instead we saw more of a steady stream of patients with dips and valleys in the graphs depicting new diagnoses, hospitalizations and death. In truth, and given our proximity to Massachusetts, which was hit quite hard by the pandemic, we were incredibly lucky to have comparatively fewer case. Once a trend in the penetration of COVID into our population was better understood, we were able to resume elective cases in early May with a slow ramping process back toward what is now a relatively normal schedule. So far, we have again been lucky that this has been a safe decision and our resources are able to handle the resumption of routine care for patients requiring joint replacement.

The pandemic has however led to a growing recognition of the merits of outpatient surgery and the transition of joint replacement to the ambulatory surgery center setting. This trend has seen a slow but steady adoption over the past few years with a relative recent acceleration as patients now seek to avoid hospitals if possible due to concerns of a higher risk of COVID exposure. As surgical techniques, anesthetic techniques and pain management programs have improved, we are now able to perform a majority of joint replacement surgeries with same-day discharge to home. This has proven both safe and satisfying for patients to avoid an overnight stay in the hospital and recover in the comfort of home. As this practice becomes the norm, it makes logical sense to transition joint replacement cases to outpatient surgery centers that not only focus on orthopedic care with a high level of expertise, but also offer less risk of exposure to sick patients.

Our practice leads the region in terms of experience both with outpatient joint replacement surgery and with performing such cases at local surgery centers that specialize in this type of care. These include Stratham Ambulatory Surgery Center and Atlantic Coast Surgical Suites. For eligible patients, undergoing joint replacement at these centers offers an excellent surgical experience that avoids the need to set foot inside the hospital. While we rely heavily on hospitals to care for sick patients, those who are undergoing joint replacement, are rarely sick and thus do not need to be in a hospital setting. If you are considering hip, knee or shoulder replacement, put our expertise to work for you.

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