Outpatient Total Joint Arthroplasty in an Academic University: Advanced Review of Concepts

There has been a recent trend towards outpatient arthroplasty since the Center for Medical Services removed the total knee and total hip arthroplasty from the inpatient only list. Arthroplasty in the ambulatory surgical center has been extensively studied, with research demonstrating better patient outcomes, better patient and surgeon satisfaction, and lower overall healthcare costs. Outpatient arthroplasty in the academic hospital setting has its own unique challenges associated with it. However there is a paucity of research pertaining to this particular setting. This review aims to evaluate the current literature and review of challenges particular to outpatient arthroplasty in the academic hospital setting. Throughout this review, evidence-based principles leading to the paradigm shift towards outpatient hip/knee arthroplasty within the hospital setting are elucidated. Additionally, practical methods for selecting appropriate candidates and optimizing perioperative care are discussed, as well as the implications of implementing outpatient arthroplasty within a university academic center.