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Complication Rates Are Not Higher After Outpatient Versus Inpatient Fast-Track Total Knee Arthroplasty: A
Jean-Yves Jenny1, Julien Godet2,
1Hôpitaux Universitaires de Strasbourg, Pôle Locomax, Strasbourg, France; Sainte Odile Clinic, ELSAN, Haguenau, France.
The Journal of Arthroplasty
|June 12, 2024
Summary
Outpatient fast-track total knee arthroplasty (FT TKA) shows no increased risk of complications compared to inpatient FT TKA. This study found similar rates of intraoperative issues, readmissions, and reoperations for both settings within 90 days post-surgery.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Patient Outcomes
Background:
- Fast-track total knee arthroplasty (FT TKA) is increasingly utilized.
- Determining the optimal setting (outpatient vs. inpatient) for FT TKA is crucial for patient safety and resource allocation.
Purpose of the Study:
- To compare complication rates and clinical outcomes between propensity-matched patients undergoing FT TKA in outpatient versus inpatient settings.
- To evaluate the safety and efficacy of outpatient FT TKA pathways.
Main Methods:
- Prospective study of 629 patients undergoing FT TKA.
- Propensity score matching (1:2 ratio) used to compare 173 outpatient and 316 inpatient cases.
- Complications tracked for 90 days, including intraoperative, readmission, and reoperation rates.
Main Results:
- No significant differences in intraoperative complication rates between outpatient and inpatient FT TKA (2% in both groups).
- Similar 90-day postoperative complication rates: no readmission (8.0% vs. 7.9%), readmission without reoperation (1.1% vs. 0.6%), and reoperation (4.0% vs. 4.4%).
- Cumulative incidence function analysis showed no significant difference in complication diagnosis time.
Conclusions:
- Outpatient FT TKA is as safe as inpatient FT TKA regarding early postoperative complications.
- Findings support the adoption of outpatient TKA pathways without increased risk.
- Encourages surgeons to consider outpatient TKA for improved patient management.
