Published on October 11, 2021

Back in Action

Patient Barbie Lorentz hiking

Barbie Lorentz considers herself an active person for her age, and rightfully so. The 66-year-old Red Bluff resident is an avid horseback rider and hiker, who rarely misses an opportunity to knock out daily 4-mile walks.

Lorentz recently returned from a trip to the Dolomite Mountains in Italy with stops in Germany, Switzerland and Austria. Even more impressive, she made the trek on a brand-new hip.

Lorentz is one of 100 patients who have had same-day joint replacement procedures at Enloe Medical Center. Meant to reduce the time a patient spends in the hospital after surgery, Enloe’s first outpatient procedure took place on May 4, 2020. Since then, Enloe’s Total Joint Replacement Program has expanded from three to four outpatient surgeries per month to eight to nine same-day operations monthly.

Brock Cummings, M.D., an orthopedic surgeon and the Total Joint Replacement Program’s Medical Director, said outpatient procedures are no different than they would be if patients had to spend the night in the hospital. Advancements in both surgical and anesthesia techniques have allowed for more surgeries to transition to either shorter hospitalizations or to outpatient procedures.

“We have been working for a long time to improve pain control and rapid mobilization after surgery,” Dr. Cummings said. “Going home the same day is just the next step in that long process.”

“We have been working for a long time to improve pain control and rapid mobilization after surgery,” said Brock Cummings, M.D., the Total Joint Replacement Program’s Medical Director.

To be eligible for the procedure, patients must be having a primary hip or knee arthroplasty, and must be able and willing to participate in the outpatient joint program pathway. They will also need to have a care partner available to attend pre-operation classes and provide around-the-clock support at home for the first three to four days after surgery. And, aside from ailing joints, patients must be otherwise healthy with very limited co-morbidities.

‘Life-Changing’ Experiences

For Lorentz, the procedure targeted a right hip that had ailed her since a fall in 2012. When the pain eventually robbed her of the joy she once got out of riding horses and hiking, Lorentz said she knew it was time to act. She had the replacement procedure on April 8, 2021, and has since returned to her active lifestyle. This time, though, she’s pain-free.

“It’s been excellent. I feel like I’m 100%,” said Lorentz, who added that she is still pacing herself during recovery. “[Sometimes] I forget I even had it done. I get to ride again, and I have confidence in my health and my hip.”

Lorentz is far from the only outpatient joint replacement success story. Beth Koch, owner of Simply Pilates in Chico, has been plagued by a painful right knee that, after more than two decades of teaching pilates and competing in half marathons, had forced the rest of her body to compensate for it. Koch was referred to Dr. Cummings and, after a consultation, decided to move forward with the replacement.

“It’s going to improve my quality of life, and that was a big reason why I made the decision to do it,” Koch said.

For Dr. Cummings, reaching 100 outpatient procedures is a nice milestone. He and his staff intentionally started slowly, he said, ensuring they were proceeding safely and ensuring the patient experience was what they had anticipated. With a wealth of successful procedures to draw on, Dr. Cummings expects the trend toward outpatient joint replacement procedures to grow.

“Having my hips done was life-changing. It gave me my life back,” said Chico resident Bonnie Worthington.

“Recent literature indicates that patients who previously were thought to be too risky to be done as outpatients can, in fact, be done without increased incidence in complications,” Dr. Cumming said. “I would expect that we will be doing well more than 50% of our hip and knee replacements as outpatients in the near future.”

It’s hard to argue with the impact it has had on several members of the community. In the case of 61-year-old Chico resident Bonnie Worthington, she sought help after both hips prevented her from horseback riding, playing tennis, golfing and going to the gym. Worthington said she thought an active lifestyle might have helped her avoid hip issues that run in her family. But when simple acts like lifting her legs into the car became unbearable, Worthington opted to operate on both hips.

“I can’t say enough great things about the process. [The staff] answered all my questions and had wonderful trainings for me and my caretaker,” Worthington said. “I went home the same day of the surgery, and in seven days I was off a walker. In two weeks, I was driving again.

“Having my hips done was life-changing. It gave me my life back.”