Feb. 11, 2019 / PRZen
/ PORTSMOUTH, N.H. -- Orthopaedic surgeon Dr. Thomas V. King has been performing knee replacements for over 30 years. Traditionally, these surgeries have involved a hospital stay for 2-3 days followed by extensive rehabilitation and a prolonged recovery. Patients were often out of work for 8-12 weeks and could not return to leisure time physical activities for 3-4 months due to persistent pain and stiffness. For years, this was considered the normal and expected recovery even for the very experienced surgeon with expertise in these procedures.
A scientist by training and an astute observer of outcomes, King, throughout his career has sought to improve not just the process of care, but to raise the bar on patient outcomes. Recognizing that up to 20% of patients continue to report some degree of discomfort after knee replacement, Dr. King felt that this was an unacceptable statistic given that more than 500,000 patients now undergo knee replacement annually in the United States.
As techniques and technology have steadily advanced, and as medicine has come to better understand how the body reacts to surgical stress, Dr. King and Kathleen Leavitt PA-C, who has worked by his side for 26 years, together began to craft a personalized care process that ultimately came to be known as AVATAR, an acronym that stands for Alignment of Vital Assets to Accelerate Recovery. The basis of this program is a focus on the end-result outcome pulling together all the assets that achieve the goal of excellence.
While many surgeons and joint replacement programs have placed heavy emphasis on the actual surgery, King and Leavitt realized that many other factors play an important role in getting patients to the goal of a great outcome. These include patient education, preparation for surgery, pre-rehabilitation, surgical stress response management, comprehensive pain management, advanced techniques in anesthesia, immediate and constant mobilization, selected physical therapy and careful monitoring of the patient after surgery. This later piece is called navigation and ensures that nothing falls through the cracks.
Over several years of refining this program, King and Leavitt now allow up to 70% of patients to go home just hours after surgery. While many hospitals are just developing a same-day surgery program, King has been performing outpatient knee and hip replacement for several years and has now performed more same-day total joint replacements than any other surgeon in New England. Modern techniques in surgery and pain management allow this to be done very safely with high levels of patient satisfaction. In fact, Dr. King has shown in his series of patients that hospital readmissions and complications have actually been lower for those patients who went home than for those who stayed in the hospital for several days.
According to King, "Until recently, we did not have the tools to do this. Now it is amazing to see what patients can accomplish with our AVATAR program. We are seeing patients achieve in 3 weeks what used to take 3 months." King further explains, "AVATAR is like a recipe. Each ingredient is critical to the final product." Inherent in this recipe is a staff of ancillary care providers including nurses, therapists and physician assistants who usher patients seamlessly through the process. "We take care of every detail in advance of the surgery, so all the patient has to do is show up. Our value proposition is our relentless commitment to excellent outcomes," Dr. King adds.
In April 2017, Dr. Moby Parsons and Stacey Riley, PA-C joined Dr. King at the Knee, Hip and Shoulder Center in Portsmouth, New Hampshire. Former medical director of the Joint Replacement Center at Wentworth Douglass Hospital, Parsons is a regional expert in knee, hip and shoulder replacement. "Moby has been a long-time friend with a similar commitment to patient care and outcomes. Adding him to our practice was a logical synergy," says King. Parsons is one of only two surgeons in New Hampshire who is an active member of the American Shoulder and Elbow Surgeons and he is a founding member of the New England Shoulder and Elbow Surgeons. "Moby has been able to adapt our AVATAR program to his expertise and extend our leadership in New England in rapid recovery."
Drs. Thomas King and Moby Parsons work at the Knee, Hip and Shoulder Center located inside Portsmouth Regional Hospital. Together they have performed more outpatient joint replacement surgeries than any other orthopaedic practice in New England and are leading experts in rapid recovery. AVATAR is a proprietary care pathway unique to this practice. Dr. King performs surgery at Portsmouth Regional Hospital and Stratham Ambulatory Surgery Center. Dr. Parsons performs surgery at Portsmouth Regional Hospital, Wentworth Douglass Hospital.
To learn more, visit: https://www.orthopedicsnh.com
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