Our Brave New World and the Transition to Ambulatory Total Joint Arthroplasty

Let me begin by wishing the readers of HSS Journal a productive and happy New Year. HSS Journal reached many milestones in 2023; the Journal is now ranked 38th among orthopedic journals, and we’ve seen a significant increase in interest in our content and in the number of submissions.

I am proud to present the inaugural issue in our 20th volume. This is a special issue dedicated to reporting the successes, challenges, and many lessons learned in the transition to short-stay total hip and total knee arthroplasty. I appreciate the multidisciplinary collaboration of the guest editors, Sharlynn Tuohy, PT, DPT, MBA, Danielle Edwards, PT, DPT, Michael P. Ast, MD, Patricia Quinlan, PhD, MPA, RN, CPHQ, and Matthew Titmuss, PT, DPT. The experience documented here reports on clinical research and administrative efforts that provided for successful transition from predominantly inpatient to same-day clinical pathways that have rapidly been adopted in many institutions over the past 2 years. Although regulatory agencies and insurers mandated many aspects of this transition, the experience reported here documents that it has been an advance in clinical care for the total joint arthroplasty (TJA) patient. The clinical research presented in these articles suggests that with appropriate planning, patient selection, and education, the transition can be made safely, with significant improvements in the patient experience. This issue also features a series of commentaries that focus on the practical steps needed from a multidisciplinary view to develop a safe and rewarding outpatient TJA program, including from nursing, physical therapy, perioperative medicine, and information technology. Together, they provide a blueprint for building an ambulatory TJA program. The guest editors for this issue provide an enlightening overview in their guest editorial.

Making the transition to ambulatory TJA is a remarkable achievement. Having been directly involved in this transition at HSS, I am aware of the massive effort required to shift practice and culture to safely implement this change in practice. It requires buy-in and participation from the entire enterprise, and the challenge often lies in convincing practitioners who have had great historical success with a traditional approach to adapt to an entirely new clinical pathway. As evidenced by the multidisciplinary clinical experience reported in this issue, such a transition can be done safely and efficiently with measurably beneficial consequences. May you find the articles instructive and helpful in adapting to this brave new world.

Supplemental Material

sj-pdf-1-hss-10.1177_15563316231213334 – Supplemental material for Our Brave New World and the Transition to Ambulatory Total Joint Arthroplasty

Supplemental material, sj-pdf-1-hss-10.1177_15563316231213334 for Our Brave New World and the Transition to Ambulatory Total Joint Arthroplasty by Charles N. Cornell in HSS Journal®