STATE COLLEGE — Until just a few weeks ago, the only place for local patients to receive joint replacement surgery in Centre County was in a hospital setting. Regardless of whether the procedures were being done on an inpatient or outpatient basis, they all took place at Mount Nittany Medical Center.
Now, there is another option. On Jan. 25, the first outpatient knee replacement surgery to be performed in a local ambulatory surgical setting took place at Geisinger Healthplex State College.
The patient was Ben Carson, 54, a farmer from Jersey Shore. After suffering from pain and swelling in his knee for well over a year, he sought medical care.
“They told me I was bone-on-bone and needed a knee replacement,” he said. “Because I have a farm, I wanted to have the surgery in January, to give me time to heal before the busy season starts.”
After doing some research on his own, he sought out Dr. Michael Sobolewski, an orthopedic surgeon with Geisinger, to perform the procedure, which he said went smoothly.
“The staff at Geisinger was fantastic from beginning to end. … My surgery started at 7:30 in the morning, and I was released by 2:30,” he said.
Since then, Carson has been faithful about going to physical therapy twice a week, and doing it on his own twice a day at home. In two weeks, he has progressed from using a walker to needing just a cane, which his therapists say he will only need for another two weeks. He should be ready to get back to the physical demands of farming in time for planting season.
“If you listen to what they tell you to do, you get better quickly,” Carson said.
This attitude is part of what made him the perfect candidate for outpatient surgery, Sobolewski said.
“As a farmer, he really knew what pain was, and he had a great attitude about his rehabilitation and what he would need to do on his recovery course. From a medical comorbidity standpoint, he was an ideal candidate as well. He also had a good support network, with the support of his wife and older children at home,” Sobolewski said.
It is crucial that patients meet all of these criteria in order to receive same-day joint replacement surgery, especially in a non-hospital setting where they do not have the option of being admitted overnight if things go wrong.
“Outpatient joint replacement is not necessarily for everyone,” he said.
In fact, currently only about 10% of joint replacement surgery is done on an outpatient basis, although Sobolewski anticipates that percentage rising in the coming years. When a patient does qualify, there are a lot of advantages to having same-day surgery, especially in an ambulatory facility.
“It’s safe, efficient and very convenient for our patients,” he said.
For one thing, there is a lower risk of picking up an infection at an outpatient clinic than in a hospital.
In addition, in order to ensure that a patient meets the proper criteria, they are evaluated very stringently, which means medical staff are less likely to be surprised by health complications. With no inpatient option to fall back on at a standalone outpatient facility like Geisinger Healthplex, patient evaluation is even more thorough, Sobolewski said, “So these patients are really getting exceptional care.”
Patients also often experience a mental and emotional lift that comes from knowing they’ll be heading home immediately to recover. “Those patients just respond differently,” he said. “They have improved confidence and a better level of patient satisfaction overall.”
