ArticleInternational orthopaedics2022
Same-day discharge to home is feasible and safe in up to 75% of unselected total hip and knee arthroplasty.
Article in International orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 22 citations in OpenAlex.
- Same-day discharge pathway for elective total hip and knee arthroplasty patients: a quality improvement project at a Canadian community hospital.BMJ open quality · 2025Article
- Implementation of outpatient hip and knee arthroplasty in a multicenter public healthcare setting.Acta orthopaedica · 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
- The five times sit-to-stand test predicts same-day discharge for outpatients undergoing total joint arthroplasty.International orthopaedics · 2024Observational
- Article
- Letter to the Editor: "Same-day discharge to home is feasible and safe in up to seventy five percent of unselected total hip and knee arthroplasty".International orthopaedics · 2022Article
- Ambulatory surgery centres: a potential solution to a chronic problem.Canadian journal of surgery. Journal canadien de chirurgieArticle
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThough numerous studies highlighted benefits of ambulatory total joint arthroplasty (TJA), most had selected patients with age and comorbidities thresholds. We aimed to report proportions of unselected TJAs that could be scheduled for and operated in ambulatory settings, and to determine factors that hinder same-day discharge (SDD).
methodsWe studied 1100 consecutive primary TJAs (644 THAs and 456 TKAs) that were prepared following a multidisciplinary protocol for patient education and logistical preparation. Data were stratified for THA vs TKA and for success vs failure of SDD to home and multivariable analysis was performed to determine factors associated with failure of scheduled SDD to home.
resultsIn total, 860 (78.2%) were scheduled for ambulatory surgery, but only 819 (74.5%) achieved SDD to home; 240 (21.8%) were scheduled for non-ambulatory surgery, but 103 (9.3%) achieved SDD to rehabilitation centre. Re-operations were required in 9 (1.0%) ambulatory TJAs vs 2 (0.8%) non-ambulatory TJAs (p = 0.769), while revisions were required in 13 (1.5%) ambulatory TJAs vs 1 (0.4%) non-ambulatory TJAs (p = 0.181). Multivariable analysis confirmed that failure of SDD to home was greater for women (OR 2.59; p = 0.011) and THA (vs TKA, OR 2.41; p = 0.023).
conclusionWith appropriate education and preparation, 75% of unselected primary hip and knee arthroplasties achieved SDD to home without compromising risks of complications, re-operations, or revisions. A further 9% achieved SDD to rehabilitation centre, implying that 84% of patients did not require overnight stay. These findings suggest that ambulatory surgery is feasible and safe to implement in most unselected lower limb arthroplasties.
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