New knees, new hips–to go

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Our 2nd Annual Innovation Issue!
Same-day Joint Replacement Steps Up

Lola Butcher

Stephen J. Zabinski, MD
Shore Orthopaedic University

New knees, new hips–to go
Bundled payment is pushing providers to look for ways to control the cost of joint replacements. Is joint replacement going to become outpatient surgery?
If you want a hip or knee replaced by Stephen Zabinski, MD, a surgeon at Shore Orthopedics Associates in Somers Point, N.J., you’re in for some homework.
If you’re a smoker, that’s got to stop; there will be no surgery if you’re aren’t nicotine-free for at least six weeks. Patients with diabetes must get their HbA1c level under control. Those with sleep apnea must document they are using the CPAP machine as per doctor’s orders. Patients with a body mass index of 45 or more must take off some weight; Zabinski’s threshold is 40 if a patient has certain comorbidities. You may need to do strength and mobility training—so-called prehab—before surgery.


Shore Orthopedics offers support for all the to-do items, but the surgeon is not going to let you off the hook. Patients must sign a contract agreeing to comply with the practice’s “total joint pathway,” and they must designate a “total joint companion” who will help them recover but also hold them accountable for following the rules. In return, Zabinski promises to get them home quickly and avoid detours to a rehab facility. He operates on Medicare patients at Shore Medical Center; some get a same-day discharge while others stay 24 to 48 hours. Most patients younger than 65 never set foot in an inpatient facility.

Hip replacements move to outpatient-style model

Hip and knee replacements have come a long way in Dr. Stephen Zabinski’s career as an orthopedic surgeon.

But one advancement is something unheard of 20 years ago – patients getting hip replacements in an ambulatory surgical center in the morning and returning home early in the afternoon.

This approach avoids possible days-long recoveries in a hospital and rehabilitation center, ultimately making it more cost effective for health care reform, he said.

Zabinski, vice president of Shore Orthopaedic University Associates, has performed these types of surgeries for more than three years and has been doing them at the Jersey Shore Ambulatory Surgical Center in Somers Point for about six months on certain patients.

“It really achieves all the goals we want to provide better care to patients in a safe way that’s more cost effective,” said Zabinski, who is the director of the Division of Orthopedic Surgery at Shore Medical Center and President of the Jersey Shore Ambulatory Surgical Center.

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Dr. Zabinski is an amazing doctor!!!

I am definitely giving Doctor Zabinski a five star rating. If I could give him more stars, I would. He is an amazing doctor!!!

I am a personal trainer and depend on my health for my job. I was devastated to find out that I needed a total right hip replacement. He reassured me that I would be back to work in time and feeling great.

11 days later I was back in the gym!
I had to take it slow but after a few weeks I was back to my old self.

I cannot thank Doctor Zabinski and his staff enough for taking such excellent care of me.
I would highly recommend him!!!!!

Susan Dascher, Somers Point, NJ

Thank you Dr. Zabinski!

Patient Testimonial:

I wanted to share photos from my New Mexico trip, they might be inspiring to your upcoming patients.

All of this climbing was done between five and seven weeks after my hip replacement. One is climbing trails, steps and ladders at Bandolier Nation Park to see the cliff dwellings. The second is climbing the dunes at White Sands National Park at Alamogordo and the last is climbing the mountains at the National Petroglyph Scenic Site near Alamogordo NM.

– James Fisher, Seaville, NJ