Feasibility, safety, and patient-reported outcomes 90 days after same-day total knee arthroplasty: a matched cohort study

Anne Mette Schmidt; Mette Garval; Kirill Gromov; Carsten Holm; Jens R Larsen; Charlotte Runge; Morten Vase; Lone R Mikkelsen; Louise Mortensen; Søren T Skou

doi:10.2340/17453674.2022.2807

Authors

Anne Mette Schmidt Elective Surgery Centre, Silkeborg Regional Hospital; University Research Clinic for Innovative Patient Pathways, Diagnostic Centre, Silkeborg Regional Hospital
Mette Garval Elective Surgery Centre, Silkeborg Regional Hospital https://orcid.org/0000-0002-0684-0997
Kirill Gromov Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre https://orcid.org/0000-0002-8114-5193
Carsten Holm Elective Surgery Centre, Silkeborg Regional Hospital
Jens R Larsen Elective Surgery Centre, Silkeborg Regional Hospital; Department of Clinical Medicine, Aarhus University, Aarhus
Charlotte Runge Elective Surgery Centre, Silkeborg Regional Hospital; Department of Clinical Medicine, Aarhus University, Aarhus
Morten Vase Elective Surgery Centre, Silkeborg Regional Hospital https://orcid.org/0000-0002-1875-229X
Lone R Mikkelsen Elective Surgery Centre, Silkeborg Regional Hospital; Department of Clinical Medicine, Aarhus University, Aarhus https://orcid.org/0000-0003-3540-7874
Louise Mortensen Elective Surgery Centre, Silkeborg Regional Hospital; Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus; Orthopaedic Research Unit, Aarhus University Hospital, Aarhus
Søren T Skou Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Ringsted-Slagelse Hospital, Denmark https://orcid.org/0000-0003-4336-7059

DOI:

https://doi.org/10.2340/17453674.2022.2807

Keywords:

Arthroplasty, Implants, Knee, Osteoarthrosis

Abstract

Background and purpose: Despite increased attention to and acceptance of fast-track procedures, there is a lack of studies concerning discharge on the day of surgery (DOS) following total knee arthroplasty (SD-TKA). We evaluated the feasibility of SD-TKA, and compared safety and patient-reported outcomes (PROs) between patients undergoing SD-TKA and patients undergoing standard TKA.
Patients and methods: A SD-TKA group (n = 101) was matched 1:1 to a standard TKA group (n = 101) on age, sex, and ASA score. Feasibility (being discharged on DOS), safety (unplanned contacts and complications evaluated by telephone calls (2 weeks), outpatient visits (2 weeks), and readmission (90 days)) were assessed. Further, Oxford Knee Score (OKS) and Visual Analogue Scale (VAS) (pain at rest and activity) were reported (90 days).
Results: 89 of 101 SD-TKA patients were discharged on DOS. The number of telephone calls (≤ 83) and outpatient visits (12) were similar in the 2 groups. The number of readmissions was ≤ 3 in both groups, and only 1 of the readmissions was related to TKA surgery. No differences were found at 90-day follow-up in terms of OKS (34 in both groups) or VAS (rest: SD-TKA = 7 and standard TKA = 8; activity: SD-TKA = 17 and standard TKA = 15).
Interpretation: SD-TKA is feasible in a selected group of patients, and safety and PROs are comparable to patients undergoing standard TKA.