Same-Day Discharge Total Knee Arthroplasty in Octogenarians

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Health Services Research

Background:

• Traditional guidelines suggest outpatient total knee arthroplasty (TKA) is best for patients under 80.
• Limited data exist on the safety of outpatient TKA for older individuals.

Purpose of the Study:

• To evaluate the risk of complications and readmissions for patients aged 80 and older undergoing outpatient TKA.
• To determine if age 80 or older should be a contraindication for outpatient TKA.

Main Methods:

• Retrospective analysis of the National Surgical Quality Improvement Program database (2011-2019).
• Propensity-matched cohort study comparing 709 octogenarians undergoing outpatient TKA with 709 undergoing inpatient TKA.
• Analysis of 30-day complications, readmissions, reoperations, and mortality.

Main Results:

• Identical 30-day readmission rates (3.5%) for both outpatient and inpatient TKA groups.
• No significant differences in major complications (2.7% vs. 2.0%), reoperations (1.3% vs. 0.8%), or mortality (0.3% vs. 0.3%).

Conclusions:

• Octogenarians undergoing outpatient TKA experienced comparable complication rates to those undergoing inpatient TKA.
• Outpatient TKA can be safely performed in select octogenarian patients.
• Age 80 and above is likely not a universal contraindication for outpatient TKA.