Recovering from total knee arthroplasty

  • Perioperative Management of Total Knee Arthroplasty in the Era of the Perioperative Surgical Home; Town Hall Meeting Style (PN117)
  • 2:20-4:20 p.m. Saturday
  • BCEC Room 252AB

Joint technology and aging baby boomers are driving the surge in knee replacement surgery. Speakers at a Saturday session will explore how following Perioperative Surgical Home processes can expedite recovery and improve outcomes for patients undergoing total knee arthroplasty.

Six speakers will explain approaches ranging from preoperative patient evaluations, prehabilitation and physical therapy to novel approaches for postoperative pain management.

Nabil Elkassabany, M.D., M.S.C.E.

“This panel has a wealth of experience, but we will limit talks to 10 minutes or less to allow ample opportunity for discussion,” said session moderator Nabil Elkassabany, M.D., M.S.C.E. Dr. Elkassabany is an Assistant Professor of Anesthesiology and Critical Care Medicine at the Hospital of the University of Pennsylvania, Philadelphia.

The first step is patient evaluation to help determine which patients may be more vulnerable to the development of complications and/or persistent pain following surgery. “If we can pick this up before surgery, we can really improve the outcomes,” he said.

A second presentation will examine updates on multimodal analgesia, focusing on niche drugs recently developed, peripheral nerve blocks and how to integrate these elements into postoperative analgesia protocols. The role of the anesthesiologist in working with and leading a team of perioperative care providers will be reviewed.

Another important pre-operative patient evaluation involves mitigation of risk factors, including diabetes and nutritional and functional status.

“If we meet these patients before surgery and get them to do some pre-rehab to get them in better shape, it can help in the recovery,” Dr. Elkassabany said. “This also can include going to the patient’s home to make sure it is ready for the patient discharge. You can make sure there are not a lot of obstacles in the way and that patients have an adequate social support network.”

Two speakers will examine options for faster recovery from the surgery, including the value of regional anesthesia versus general anesthesia and making total knee arthroplasty an outpatient procedure.

The final presentation will evaluate emerging technology in postoperative pain management. These new approaches include nerve stimulation rather than peripheral nerve blocks, cryotherapy and radiofrequency ablation.

“We want to highlight the role of the anesthesiologist in improving outcomes. It has become obvious in this day and age that anesthesiologists have expanded their roles in prepping patients for every stage of surgery,” Dr. Elkassabany said.

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