General vs Spinal Anesthesia for Total Joint Arthroplasty: A Single-Institution Observational Review

Area of Science:

• Anesthesiology
• Orthopedic Surgery
• Patient Outcomes

Background:

• Total joint arthroplasty (TJA) can be performed under general anesthesia (GA) or spinal anesthesia (SA).
• Optimal anesthetic technique for TJA remains unclear in existing literature.
• This study aims to compare TJA outcomes based on anesthesia type.

Purpose of the Study:

• To prospectively compare the effects of spinal anesthesia (SA) versus general anesthesia (GA) on total joint arthroplasty (TJA) outcomes.
• To identify the optimal anesthetic technique for TJA procedures.
• To evaluate complication rates and healthcare resource utilization associated with different anesthesia methods.

Main Methods:

• A 2-year prospective, observational study involving consecutive patients undergoing primary TJA.
• Postoperative follow-up to assess 90-day complications.
• Primary outcome measure was the overall complication rate.

Main Results:

• 2242 patients (hip: 29.26%, knee: 70.74%) underwent TJA; 59.10% received SA, 40.90% received GA.
• GA cohort had higher comorbidity index and BMI.
• SA group showed significantly lower overall complication rates (7.02% vs 10.14%), shorter length of stay, and fewer nursing facility discharges compared to GA.

Conclusions:

• Spinal anesthesia (SA) for TJA is associated with reduced overall complications.
• SA is linked to decreased healthcare resource utilization, including shorter hospital stays.
• SA may be a preferred anesthetic technique for TJA, improving patient outcomes.