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Outpatient total knee arthroplasty: is it worth considering?
1Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain.
EFORT Open Reviews
|April 17, 2020
Summary
Outpatient total knee arthroplasty (TKA) may be successful for select patients but carries higher risks. Current evidence suggests it should not be broadly recommended due to a lack of universal selection criteria.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Patient Management
Background:
- Outpatient total knee arthroplasty (TKA) has been reported as successful, safe, and cost-effective for advanced osteoarthritis.
- Success is attributed to multidisciplinary teams, standardized protocols, discharge planning, and patient selection.
Purpose of the Study:
- To evaluate the safety and efficacy of outpatient total knee arthroplasty.
- To identify patient selection criteria for outpatient TKA.
- To determine if outpatient TKA is generally recommendable.
Main Methods:
- Review of existing literature on outpatient TKA outcomes.
- Comparison of perioperative surgical and medical outcomes between outpatient and inpatient TKA.
- Analysis of patient characteristics in reported outpatient TKA cases.
Main Results:
- One study indicated higher risks of component failure, surgical site infection, knee stiffness, and deep vein thrombosis in outpatient TKA.
- Outpatient TKA has primarily been performed in younger patients with few comorbidities.
- Universal patient selection criteria for outpatient TKA are lacking.
Conclusions:
- Outpatient TKA shows potential but carries increased risks compared to inpatient procedures.
- The procedure is not yet clearly beneficial except for highly selected young patients without comorbidities.
- General recommendation for outpatient TKA is not advised at this time.
