Transition to outpatient total hip and knee arthroplasty: experience at an academic tertiary care center Arthroplasty Today Published:
November 2018 Finding:
Retrospective review of 105 patients who underwent outpatient THA or TKA following an outpatient protocol compared to inpatients from the same time period. Outpatient readmission and complication rates (0.95%, 1.9%) were better than inpatient rates (3.7%, 2.9%). Authors conclude that Outpatient THA and TKA in a well-selected patient is feasible in an academic multidisciplinary tertiary care hospital, with complication rates approximating inpatient surgery. The findings reported can be used to further optimize outpatient arthroplasty protocols.
Inpatient Versus Outpatient Hip and Knee Arthroplasty: Which Has Higher Patient Satisfaction? The Journal of Arthroplasty Published:
July 2018 Finding:
Although satisfaction was high in both outpatient and inpatient groups, when differences were present, patients favored outpatient surgery in the ambulatory surgery center.
Is Outpatient Unicompartmental Knee Arthroplasty Safe to Perform at an Ambulatory Surgery Center? A Comparative Study of Early Post-Operative Complications The Journal of Arthroplasty Published:
March 2018 Finding:
A review of 569 outpatient unicompartmental knee arthroplasties performed 2012 to 2016 (288 ASC, 281 HOPD) revealed no difference in overall complication rate between the two settings.
Quality of Recovery, Postdischarge Hospital Utilization, and 2-Year Functional Outcomes After an Outpatient Total Knee Arthroplasty Program The Journal of Arthroplasty Published:
February 2018 Finding:
Authors compared 43 inpatients and 43 outpatient TKAs between 2010 and 2015 by a single surgeon. Patients were given a diary to complete at post-discharge intervals, and study tracked 90-day complications, readmissions, and ED visits. Outpatient TKA in selected patients produced similar short-term and 2-year patient-reported outcome measures and a comparable 90-day post-discharge hospital resource utilization when compared to an inpatient cohort, supporting further investigation into outpatient TKA.
The outpatient total hip arthroplasty: a paradigm change The Bone and Joint Journal Published:
January 2018 Finding:
Authors reviewed 1,472 total hip arthroplasties (THAs) performed at an ASC between 2013 and 2016. They found a low complication rate (2.2%) despite the fact that 44% of the patients observed had one or more major comorbidities. Based on this, they conclude that in their population comorbidities was not associated with medical or surgical complications and that outpatient THA is safe for a large proportion of patients without the need for a standardized risk assessment score.
Hand Surgery in the Ambulatory Surgery Center Orthopedic Clinics Published:
January 2018 Finding:
65% of hand surgeons report doing most of their surgery at an ASC, and in 2006, 49% of carpal tunnel release procedures were done in ASCs (up from 16% in 1996). Use of ASCs for hand surgery is more cost-effective and efficient than an inpatient facility, with a low (0.2%–2.5%) complication rate.
Outpatient total shoulder arthroplasty in an ambulatory surgery center is a safe alternative to inpatient total shoulder arthroplasty in a hospital: a matched cohort study The Journal of Shoulder and Elbow Surgery Published:
February 2017 Finding:
Comparing two samples (30 patients matched for age/comorbidity) of patients undergoing total shoulder arthroplasty at an ASC and an inpatient hospital, there was no significant difference in 90-day episode-of-care complication rates
such as hospital admission/readmission.
The Safety of Hand and Upper-Extremity Surgical Procedures at a Freestanding Ambulatory Surgery Center: A Review of 28,737 Cases The Journal of Bone and Joint Surgery Published:
April 2016 Finding:
A retrospective review of 28,000+ cases found an overall low (0.20%) rate of adverse events (defined as serious complications leading to patient harm or additional treatment).