Orthopedic outpatient surgery

Changes in provision of health care by the province of Ontario have included forced reduction in the number of hospital beds. In this situation the needs of patients with orthopedic disabilities have been met by a dramatic increase in outpatient surgery. At the Hotel Dieu Hospital, Kingston, the total number of surgical procedures increased from 5516 in 1970 to 7260 in 1975. During this period the number of outpatient surgical procedures performed under general anesthesia rose from 820 in 1970 to 2927 in 1975, an increase of 264%. Of 1197 orthopedic procedures performed in 1975, 632 (52%) were performed on an outpatient basis. In the author's personal experience of outpatient surgery, which in 1975 included 38 meniscectomies, 10 major shoulder repairs, 28 foot reconstructions, 11 nerve releases, 14 tendon releases and 4 elbow arthroplasties, patient acceptance has been good. Adequate clinic facilities, trained nurses, appropriate anesthesia and patient education are essential if management in this locale is to be successful.