ArticleInternational orthopaedics2019
Defining growth potential and barriers to same day discharge total knee arthroplasty.
Article in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Outpatient total knee arthroplasty leads to a higher number of complications: a meta-analysis.Journal of orthopaedic surgery and research · 2020Pooled it
- Assessing social disparities in inpatient vs. outpatient arthroplasty: a in-state database analysis.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Time from surgery end to discharge following total knee arthroplasty: implications for same day discharge.Archives of orthopaedic and trauma surgery · 2024Article
- Half of all hip and knee arthroplasty patients may be potential day-case candidates: a nationwide register study of 166,730 procedures.Acta orthopaedica · 2024Article
- Association of Total Knee Replacement Removal From the Inpatient-Only List With Outpatient Surgery Utilization and Outcomes in Medicare Patients.JAMA network open · 2023Article
- Fostering Excellence in Knee Arthroplasty: Developing Optimal Patient Care Pathways and Inspiring Knowledge Transfer of Advanced Surgical Techniques.Journal of healthcare leadership · 2023Article
- Same-day discharge to home is feasible and safe in up to 75% of unselected total hip and knee arthroplasty.International orthopaedics · 2022Article
- Failure to Meet Same-Day Discharge is Not a Predictor of Adverse Outcomes.Archives of orthopaedic and trauma surgery · 2022Article
- Outpatient surgery in patients with ankle fractures minimises hospital admissions and utilisation of healthcare resources.International orthopaedics · 2021Article
- Total Knee Arthroplasty in Ambulatory Surgery Centers: The New Reality!Arthroplasty today · 2020Article
- Physician leadership and system redesign needed to scale same-day discharge hip and knee arthroplasty.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
- Management of patients undergoing same-day discharge primary total hip and knee arthroplasty.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Review
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOutpatient arthroplasty programs are becoming well established. Adverse event rates have been demonstrated to be no worse than inpatient arthroplasty in the literature for selected patients. The purpose of this study was to determine our rate of outpatient total knee arthroplasty (TKA), examine justification for exclusions, and estimate the proportion of TKAs that can occur safely on an outpatient basis.
methodsRetrospective case series of 400 consecutive TKAs from Oct 2014 to Mar 2017. Patient demographics, allocation to outpatient surgery vs standard admission, and reason for exclusion from outpatient surgery were recorded. Ninety-day Emergency department (ED) visits, readmission rates, and length of stay (LOS) were compared between groups using independent sample t test and Chi-squared test.
resultsOutpatients were younger (p = 0.001), had lower BMI (p < 0.001), and ASA scores (p < 0.001) than inpatients. One hundred twenty-five (31%) TKAs were assigned to outpatient surgery and 123 achieved discharge on the same day. There was no difference in 90-day ED visits (p = 0.889) or readmission rates (p = 0.338) between groups. Reasons for exclusion from outpatient surgery included medical (absolute 43% and relative 31%), distance > one hour from hospital (18%), no help (7%), and other/unclear (10%). LOS was significantly longer for medical than non-medical exclusions (p < 0.001) and for the absolute compared to relative medical exclusions (p = 0.004).
conclusionOutpatient TKA is safe in selected patients, and inclusion can likely be broadened by addressing modifiable exclusions and narrowing medical exclusions. We found that 55% of our TKA population could be appropriate for outpatient surgery.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.