Patients' Perceptions and Experiences With Outpatient Hip and Knee Arthroplasty: A Qualitative Study.

Background Outpatient joint arthroplasty (OJA) of the hip and knee is becoming increasingly popular within the orthopedic community. Most evidence regarding the safety and feasibility of OJA has been gathered from the perspectives of surgeons and healthcare organizations. However, the success of these pathways also hinges on patients feeling safe and adequately prepared to return home. This study aimed to explore patients' perspectives, experiences, and challenges during the preoperative phase, the day of surgery, and the postoperative phase of outpatient total hip arthroplasty (THA) or total knee arthroplasty (TKA). Patient satisfaction was also assessed. Materials and methods Twelve patients who underwent outpatient THA or TKA and their informal caregivers participated in face-to-face, semi-structured interviews. The transcripts were analyzed using thematic analysis, following the Grounded Theory approach. Results OJA was well received by patients, with 33% making a patient-driven decision to undergo the pathway, while the majority supported the idea following their surgeon's recommendation. Key areas for enhancing the patient experience included better preoperative education and expectation management, streamlined pathway logistics, and reassurance through robust intra- and extramural safety nets. Notably, 92% of patients indicated they would choose OJA again over an inpatient procedure if faced with the same decision. Conclusions Although patients were generally very satisfied with outpatient THA and TKA, the findings create scope to refine existing pathways further. Additionally, interview insights suggest potential improvements to patient selection criteria to identify suitable candidates for OJA better.