A U G U S T 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 1 1
Ankles arrive
Surgeon Erik Nilssen, MD, an ankle
specialist at Andrews ASC, says
patients and payers are becoming
more interested in outpatient ankle
replacement. "Implant companies
have been focusing on total knees
and total hips, because that's where
the patient demand has been," he
says. "But instrumentation and
implants included in total ankle sys-
tems have improved dramatically in
recent years. The quality and
longevity of the repairs are evolving
to match the positive outcomes
achieved in hip and
knee replacements."
Because Medicare
doesn't yet reimburse
surgery centers for total
joint cases, Dr. Nilssen
has no choice but to per-
form total ankle proce-
dures at the hospital
across the street from the
Andrews ASC. Most of
his ankle patients have
had traumatic injuries or
suffer from genetic
osteoarthritis. The typical patient is
older, with long-standing degenerative
ankle arthritis, but Dr. Nilssen is see-
ing more younger patients seeking the
surgery. He recently operated on a
woman in her late 30s. The 33 joints in
her foot were pristine, but the ankle
joint was shot. Ankle fusion has long
been the gold standard for treating her
condition, but replacing the diseased
portions of the joint instead of fusing
the ankle preserves the range of
motion in both the ankle and foot.
That's especially important in young,
active patients, says Dr. Nilssen.
"The incisions are smaller and it's
a smaller joint to manage, but in
I
t's hard not to take notice when the renowned
Andrews Institute Ambulatory Surgery Center
in Gulf Breeze, Fla., decides to capitalize on
one of surgery's hottest trends by adding total
ankles, shoulders and knees to its case mix.
The Andrews ASC team realizes what you should, if
you haven't already: Excellent clinical outcomes,
incredible growth potential and promise of signifi-
cant profits are turning the continued migration of
joint replacement patients to outpatient settings
into a stampede, albeit a limping one.
