Changes to Anticipated Disposition Prevent Timely Discharge After Total Joint Arthroplasty

This study evaluates the impact of preoperative disposition planning on length of stay (LOS) after total joint arthroplasty (TJA). A retrospective chart review, including patients undergoing primary TJA, was performed. Demographics, social factors, Risk Assessment and Prediction Tool (RAPT) scores, and predicted and actual disposition were used to analyze patients that exceeded their expected LOS. Six hundred seventy-nine patients met the inclusion criteria. Average predicted and actual LOS were 2.4 and 2.7 days, respectively. Three hundred thirty-six patients exceeded their anticipated LOS. The most significant factor for exceeding LOS was a change in disposition (p < 0.001). Eighty-two patients had a change in disposition. Patients that required a higher (40) or lower (42) level of care had prolonged LOS (p < 0.001). A change to either higher or lower levels of care than preoperatively anticipated results in increased LOS after TJA. (Journal of Surgical Orthopaedic Advances 34(2):093-097, 2025).