Outpatient Total Joint Arthroplasty: Future Directions

➢ Over the past 4 decades, total joint arthroplasty (TJA) has transitioned from primarily an inpatient procedure to a procedure increasingly performed in outpatient settings, driven by advancements in perioperative care protocols, regional anesthesia, reimbursement models, and a shift in cultural expectations. ➢ Studies have shown that outpatient TJA can be performed with similar surgical outcomes compared with inpatient TJA, provided that there is appropriate patient selection and optimization of perioperative management. Patient selection for outpatient TJA relies on risk assessment, utilizing scoring systems and consideration of social factors and support systems for the patients. Key aspects of perioperative management include patient education, rehabilitation, and optimized pain control strategies, which are essential for the success of same-day discharge and the minimization of complications. ➢ The transition to outpatient TJA aligns with the increasing demand for TJA and rising health-care costs, representing a shift toward value-based care and a change in clinical practice. Outpatient TJA has been shown to have optimal patient outcomes and cost-efficiency, contributing to the overall sustainability of health-care practices.