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Outpatient Total Hip Arthroplasty in the United States: A Population-based Comparative Analysis of Complication Rates

Armin Arshi1, Natalie L Leong, Christopher Wang

  • 1From the Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA (Dr. Arshi, Dr. SooHoo), the Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL (Dr. Leong), the Department of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA (Dr. C. Wang, Dr. Buser, Dr. J. C. Wang).

The Journal of the American Academy of Orthopaedic Surgeons
|September 25, 2018
PubMed

Insights

Outpatient total hip arthroplasty (THA) shows comparable complication rates to inpatient THA. This growing trend offers a safe and cost-effective option for carefully selected patients.

Area of Science:

  • Orthopedic Surgery
  • Health Economics

Background:

  • Rising healthcare costs necessitate exploring cost-effective surgical options.
  • Outpatient arthroplasty presents a potential solution for select patient groups.

Purpose of the Study:

  • To compare complication rates of outpatient total hip arthroplasty (THA) versus traditional inpatient THA.

Main Methods:

  • Retrospective review of insurance records (2007-2016) for THA patients.
  • Multivariate logistic regression analysis adjusted for age, gender, and comorbidity index.
  • Comparison of surgical and medical complication rates between outpatient and inpatient cohorts.

Main Results:

  • Outpatient THA patients had fewer comorbidities (hypertension, cerebrovascular disease, obesity, COPD, CKD).
  • Adjusted analysis revealed comparable rates of surgical complications (revision, debridement, dislocation) and medical complications at 1 year.
  • Both outpatient and inpatient THA incidence increased during the study period.

Conclusions:

  • Outpatient THA is increasingly common and demonstrates comparable postoperative complication rates to inpatient procedures.
  • Outpatient THA is a safe and effective alternative for appropriately selected patients, potentially reducing healthcare costs.
Abstract

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