Comparison of outpatient versus inpatient total knee arthroplasty

New protocols have been designed for outpatient total knee arthroplasty procedures, but concerns exist about the potential for increased complication rates. We compared the results of two selected matched cohorts of 64 patients who underwent total knee arthroplasty during the same time period. One cohort of patients, who had no severe medical conditions, lived within one hour of the office, and had help at home, followed an accelerated pathway in which they were discharged within 23 hours of surgery, and the other cohort followed a standard inpatient protocol, with a mean hospital stay of 2.3 days (range, 2-4 days). There were no perioperative complications in either cohort, and none of the patients who followed the outpatient protocol returned to the hospital for any reason. At a mean followup of 24 months (range, 12-41 months), the mean Knee Society knee scores of the outpatient and inpatient cohorts were 96 points (range, 67-100 points) and 95 points (range, 78-100 points), respectively. The mean Knee Society function scores were 89 points (range, 50-100 points) and 90 points (range, 60-100 points), respectively. We believe outpatient total knee arthroplasty may be a safe procedure in certain selected patients, with similar outcomes to a traditional protocol.

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.