Routine Postoperative Laboratory Tests Are Unnecessary After Partial Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Health Economics

Background:

• Partial knee arthroplasty (PKA) is increasingly performed outpatient.
• Many surgeons still admit patients overnight and order postoperative lab studies.

Purpose of the Study:

• Investigate the utility of routine postoperative laboratory studies after PKA.
• Assess the cost-effectiveness of routine postoperative laboratory studies after PKA.

Main Methods:

• Retrospective review of 322 unilateral or bilateral simultaneous PKAs.
• Analysis of 408 complete blood counts and basic metabolic panels ordered postoperatively.

Main Results:

• A 1.6% rate of laboratory-associated interventions for hypokalemia or hyperglycemia in 5 patients.
• No red blood cell transfusions were required.
• Total hospital charges for laboratory studies amounted to $85,413.
• No 90-day readmissions or ED visits were linked to abnormal lab values.

Conclusions:

• Low rate of laboratory-associated interventions suggests routine postoperative lab studies are unnecessary.
• Routine laboratory studies after PKA are not cost-effective.
• Emphasis on cost containment supports discontinuation of routine postoperative lab studies.