Overnight Admission After Total Ankle Replacement: Is It Safe?

Area of Science:

• Orthopedic Surgery
• Patient Outcomes Research

Background:

• Total ankle replacement (TAR) is a procedure for end-stage ankle arthritis.
• Optimizing patient recovery pathways, including length of stay, is crucial for improving surgical outcomes and resource utilization.

Purpose of the Study:

• To compare readmission, complication, and unscheduled outpatient contact rates after total ankle replacement for patients discharged after 1 day versus those with longer inpatient stays.
• To assess the safety and efficacy of overnight admission protocols for total ankle replacement.

Main Methods:

• Retrospective data collection from December 11, 2015, to December 1, 2019.
• Inclusion of 116 patients undergoing total ankle replacement with a minimum 3-month follow-up.
• Comparison of outcomes between patients discharged after 1 day and those with inpatient stays longer than 1 day.

Main Results:

• No significant differences in patient characteristics, readmission rates (2.6% overall), complication rates (6.0% overall), or unscheduled outpatient contacts (20.7% overall) were observed between the overnight and inpatient admission groups.
• Approximately 58.6% of patients were discharged as planned.
• Specific complication types, readmission reasons, and reasons for outpatient contact did not differ between the admission groups.

Conclusions:

• Total ankle replacement with overnight admission is a safe approach.
• Careful patient selection, robust post-discharge pain management strategies, and appropriate cast application are critical for successful outcomes.