ArticleBMC medicine2025
Day case hip and knee replacement in England: a population-based cohort study using linked National Joint Registry and Hospital Episode Statistics data.
Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- An update on the role of multimodal analgesia in perioperative pain management.Korean journal of anesthesiology · 2026Review
- National survey of protocols for day-case hip and knee arthroplasty in the UK.Bone & joint open · 2026Article
- Safety and efficacy of day-case hip and knee arthroplasty in the NHS: a nationwide UK cohort study.Arthroplasty (London, England) · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundIn response to rising demand, disruptions from the COVID-19 pandemic, and the need for improved cost-effectiveness, the way hip and knee replacements are being delivered is rapidly changing. Increasingly, they are being performed as day case procedures without an overnight stay in hospital. This study assessed the safety of this for a national cohort of NHS-funded procedures in England.
methodsData from the National Joint Registry, Hospital Episode Statistics, and Civil Registration of Deaths databases were linked to identify patients who underwent total hip replacement (THR) and total or unicompartmental knee replacement (TKR/UKR) in England between 2010 and 2022. Outcomes including 30-day readmissions, 90-day serious adverse events, and 1-year reoperations were compared between day case and one-day stay inpatients using adjusted flexible parametric survival models.
resultsThe study included 7485 day case and 60,747 one-day stay inpatient procedures. Day case surgery was associated with a higher risk of 30-day readmission for THR (adjusted relative risk (RR) 1.28, 95% CI 1.07 to 1.53) and TKR (RR 1.28, 95% CI 1.10 to 1.48). A learning curve was observed where the first 6-day case THRs and the first 4-day case TKRs per unit carried significantly higher readmission risk. There were no differences in 90-day serious adverse events. However, day case TKR was associated with an increased risk of reoperation within 1 year (RR 1.50, 95% CI 1.15 to 1.96; NNTH 84), most commonly manipulation under anaesthesia (MUA). No significant differences were found for UKR.
conclusionsDay case UKR appears safe. Day case THR is generally safe, and although there is a higher risk of readmission in the first six procedures at each unit, other safety outcomes are not different. However, day case TKR carries an increased risk of reoperation, mainly for MUA which is typically performed for postoperative stiffness.
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