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cally outlive their implants. Worth the effort Hip replacement is a game-chang- ing treatment for patients who often consult with a surgeon on the heels of several failed conser- vative interventions. Many patients who opt for surgery have already tried several treatment options before their surgeons rec- ommend finally fixing the underly- ing cause of their joint discomfort. We still have some restrictions for Medicare patients, but private insurers are pushing younger patients to have their procedures performed in outpatient ORs. From a financial standpoint, it makes a lot of sense to do these procedures that way, because it saves the healthcare system, insurance companies and patients a lot of money. Typically, a total-hip replacement performed as outpatient costs half or less than half of what it does as an inpatient procedure — without sacrific- ing the quality of the care patients receive. This provides a lower cost benefit for the payer and allows patients to greatly reduce their copays and out-of-pocket expenses. Total hip replacements can be performed fairly quickly and provide immediate relief for patients who have likely been suffering for years with debil- itating joint pain. Patients are very grateful to live life with pain-free joints, and it's a very successful endeavor for surgical facilities from a business standpoint. It's really a feel-good type of medicine and it's great to give quality of life back to patients. It takes a high level of commitment from all providers involved to make a hip replacement program work, but the benefits to your facility, the healthcare system and, of course, patients are undeniable. OSM timodal approach, meaning we give patients differ- ent medicines that treat their pain in different man- ners to decrease the amount of opioids used post- operatively. This approach has been very success- ful, and we have been able to substantially decrease the amount of opioids used as a result. We're also doing a much better job of managing patients' pain because of the precision of anesthesia. We use regional anesthesia (spinal) and then perform a peri-articular block with a mixture of long-acting local medications and pain medicines. The combina- tion of multimodal analgesia and regional anesthesia allows us to treat the patient's pain post-operatively more effectively and has helped us to initially decrease a patient's stay at the hospital and now to perform the procedures on an outpatient basis. Before surgery, patients receive a preoperative evaluation that includes a physical therapy session, during which they become familiar with what will be required of them to help advance the healing process after surgery. Patients go to physical thera- py the day after surgery and typically schedule ses- sions three days a week for two to six weeks post- op. It really is a remarkably quick recovery process, and patients feel immediate relief from their pain following the procedure. Patients who undergo successful hip replace- ment surgery — especially in their older age — typi- 1 0 • S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 2 0 HEALING HELP Patients should undergo a preoperative evaluation with a physical therapist, who can set expectations for post-op rehab requirements. Dr. Dellose (sdellose@aol.com) is an orthopedic surgeon at Delaware Orthopedic Specialists in Wilmington.