Spearfish Surgeons Now Offering Same Day Outpatient Total Joint Procedures

By: Alex Strauss

Three orthopedic surgeons with Regional Health Orthopedics in Spearfish, South Dakota have begun replacing hips, knees, and shoulder joints on an outpatient basis in select patients.

“An outpatient joint replacement is much like having a knee or shoulder scope in that you come

in at 6 or 6:30 in the morning and you leave shortly after noon,” says Kipp Gould, DO, who specializes in hip and knee replacements at Regional Health Spearfish Hospital.

Along with his colleagues Ray Jensen, DO, and Richard Little, MD, Dr. Gould has been offering the outpatient option to patients younger than 65 for about six months.

“If you are over 65, Medicare requires that we keep you overnight,” says Dr. Gould. “Otherwise, interested patients are sent to our surgical clearance physician for a workup of their heart and lungs.” Those who are deemed to be healthy enough for a same day total joint procedure attend a presurgical joint camp the week before.

“The more you know about the procedure you’re going to have, the less trepidation you have and the better you are likely to do,” says Dr. Gould.

In addition to careful patient screening and preparation, Dr. Gould says improved surgical

techniques and a powerful, long-acting interoperative pain medication called Exparel have made it possible to cut length of stay from just over a day (already better than many area institutions) to just a few hours.

“This is an injection that we do during the procedure which lasts for about 72 hours,” says Gould. “Before we started using this, our first ambulation was about 30 feet. Not’s it’s 300 feet. So that has been a big factor.”

Although Gould says same day total joint replacements are on the rise around the country, they are more often offered at private surgery centers. “It is unique that we are able to do this in a hospital setting. Usually, it is difficult to get the administration on board, but ours has been very supportive. I would be shocked if there were other hospitals our size in a rural setting offering this.”

As more people become aware of the availability of these procedures in Spearfish, Dr. Gould says he expects about 30 percent of his total joint patients to choose the outpatient option.