Hampton’s COASC is the only area facility offering total joint replacement surgery for outpatients.
Historically, a total knee, shoulder or hip surgery might have required a few days overnight in the hospital.
But with the rise of ambulatory surgery centers, surgeries that used to require a hospital stay are now being done on an outpatient basis. Many of these surgeries are being done more efficiently and safely, allowing the patient to recuperate at home while at the same time significantly saving costs.
The CarePlex Orthopaedic Ambulatory Surgery Center in Hampton, Va., is the only dedicated orthopedic facility in Hampton Roads offering total joint replacement surgery as an outpatient procedure. Patients who visit the 55,000-square-foot, state-of-the-art facility — also known as the COASC — on the campus of Sentara CarePlex Hospital can have a new shoulder, hip, or knee and return home that same day.
“There is no other facility like it in this region,” says Dr. Loel Payne, a knee and shoulder specialist at Tidewater Orthopaedics. “Everyone on the team is committed to providing the best possible care available anywhere.”
The COASC follows a trend in ambulatory surgery centers, or ASCs, to offer more outpatient services. According to Sg2, a healthcare intelligence service, outpatient surgeries are expected to increase 11 percent over the next five years with the shift to value-based care.
“Replacements at an ASC have been shown to offer a significant cost savings, and patients are able to recover in the comfort of their home,” Payne says.
With the latest in orthopedic equipment, including 4K technology that allows doctors to see into the joint with more clarity, surgeons are able to provide top-notch care and cutting-edge techniques for patients suffering from a wide range of orthopedic issues, says Dr. Nicholas Sablan, COASC’s medical director. All of COASC’s surgeons are from Tidewater Orthopaedics, which is based in Hampton and Williamsburg.
“We are the only orthopedic-dedicated facility in the area, and our staff is performing nothing but orthopedic cases five days a week,” says Brandon Thompson, COASC’s administrator. “From pre-op through the O.R. and recovery, every team member works with the surgeons to create the optimal care for the patients.”
The highly specialized training by doctors and staff — the entire staff only focuses on orthopedics — is just one of the reasons that the center has a less than .0001 percent infection rate, Thompson says. That’s one of the best infection rates in the country.
The low chance of a hospital-acquired infection is one of the reasons Jim Risher chose the COASC and Dr. Michael Higgins for his hip replacement. Higgins, who specializes in hip and knee replacement surgery, developed the COASC’s Healthy Patient Model, an approach to elective surgery that reduces recovery time and patient costs by eliminating the need for extensive hospital stays.
The Healthy Patient Model is a comprehensive patient-care philosophy based on the idea that patients who choose to have elective surgery are not sick.
Think of it as “well patients having well surgeries.” The model focuses on preoperative screening and education, preoperative physical therapy (when needed), pain management, rapid mobilization after surgery, minimal hospital stay, and outpatient PT within 3-10 days. Results for the patient include less time in the hospital, lower chance of infection, lower complication rates, faster recovery, and less need for pain medicine.
“They control their own operating rooms,” says Risher, a 51-year-old former professional soccer player from Newport News who had surgery in March after several years of progressive, chronic pain. “That was a huge factor for me as I have heard of others who went with other doctors for hip replacement and ended up with infections. My desire was to lower the risk factors as much as humanly possible.”
The center’s list of available procedures is extensive, offering carpal tunnel surgery, rotator cuff and ACL repairs, cervical disc spine fusions and foot and ankle procedures in addition to total shoulder, knee and hip replacements. About 3,600-3,700 total cases are done each year. Since the COASC started doing outpatient procedures in 2016, there have been 40 outpatient total joint replacement procedures performed.
Teck-Seng Kwa, of Newport News, was the first patient to undergo outpatient knee reconstructive surgery with Dr. Colin Kingston, a sports medicine and knee surgeon, who Kwa described as “very thorough during the consultation, explaining all the necessary steps and the surgery center. That answered all the doubts I had.”
Since the 59-year-old’s right knee was reconstructed in Nov. 2016, “I have no problem walking and doing all my outdoor activities just like before I had my knee problems,” Kwa says.
Each patient is paired with the surgeon who specializes in a certain part of the body, be it knee, shoulder or ankle, along with a patient navigator who guides patients through each step before and after surgery. The great majority of surgeries are able to be done with regional anesthesia instead of general, which allows a much faster recovery time with less pain. All these factors, Kingston says, result in better outcomes, fewer complications and “our exceptional patient satisfaction.”
“This allows us to be one of the most proficient health care teams in the world,” says Kingston, a former Air Force flight surgeon. “Of the over 100 civilian and military hospitals that I have operated in around the world, the COASC is by far the best place to have an elective orthopedic procedure.”
One of the things that most impressed patient Kimberly Jarvis was the level of care, says the 46-year-old, who works at the Newport News shipyard as a pipefitter instructor and injured her shoulder a number of years ago. She chose Payne after researching orthopedic surgeons online.
“He stood out from other doctors,” Jarvis recalls. “He took the time to really listen to me.”
Despite a painful recovery following her partial shoulder replacement in June 2016, Jarvis says she’s been able to resume everyday activities and job duties with little or no pain. She continues to see Payne for other joint issues.
Three years after his first shoulder surgery, which required an overnight hospital stay, Toano resident Vincent Sakony returned to Sablan, a sports medicine and shoulder specialist, and underwent outpatient total joint replacement surgery on his left shoulder in 2016. He went in at 7:30 a.m. and walked out the door four hours later.
“The recovery was just fantastic,” says Sakony, who is 68. “People could not believe the full range of motion I had.”
“Before the surgery, I was going to my family doctor, and he was recommending things to do for my shoulder,” Sakony adds. “When I told him I was going to see Dr. Sablan he said, ‘I don’t recommend that because you’ll never have full range of motion. I don’t know anybody who has had total replacement surgery and had full range of motion.’ So about two months after I had the procedure I walked into his office and I had my arms over my head scratching my back and I asked, ‘Do you notice anything?’ ”
If you or someone you know is suffering from chronic joint pain and conservative treatments do not seem to be working, consider the outpatient procedures offered at the CarePlex Orthopedic Ambulatory Surgery Center. Call 757-736-4100 or visit careplexortho.com for more information.
