Safety Considerations for Outpatient Arthroplasty

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Health Services Research

Background:

• Outpatient total joint arthroplasty (TJA) has seen a significant rise since 2018.
• Surgeons and anesthesiologists must understand the safety implications and patient risk factors associated with outpatient TJAs.

Purpose of the Study:

• To review the safety profile of outpatient total joint arthroplasty.
• To identify critical patient selection criteria and optimization strategies for outpatient TJA programs.

Main Methods:

• Analysis of large-scale database studies comparing outpatient and inpatient arthroplasty outcomes.
• Review of potential patient exclusion criteria and optimization needs.

Main Results:

• While smaller studies suggest equivalent risks, larger analyses indicate a potential increase in surgical or medical complications for outpatient TJA patients, even with matched comorbidities.
• Key exclusion criteria may include advanced age, bleeding disorders, history of deep vein thrombosis, uncontrolled diabetes, and hypoalbuminemia.

Conclusions:

• Appropriate patient selection is paramount for successful outpatient TJA programs.
• Further large-scale research is needed to evaluate the risks associated with same-day versus next-day discharge in outpatient TJA.