Day-case hip and knee arthroplasty does not increase healthcare system contacts: a prospective multicenter study in a public healthcare setting
DOI:
https://doi.org/10.2340/17453674.2025.43001Keywords:
Arthroplasty, Hip, Knee, OsteoarthrosisAbstract
Background and purpose: Discharge on day of surgery after hip or knee arthroplasty is increasing, but whether this leads to an increase in the overall number of post-discharge healthcare system contacts is unknown. We aimed to investigate whether day-case surgery leads to increased patient-reported healthcare system contacts compared with non-day-case surgery within the first 30 days postoperatively.
Methods: We performed a prospective multicenter study at seven fast-track centers from September 2022 to August 2023. Candidates for primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or unicompartmental knee arthroplasty (UKA) were evaluated for day-case eligibility using pre-defined criteria. Patients received a survey 30 days postoperatively regarding any healthcare system contacts related to surgery. Planned healthcare visits were excluded. We used day-case eligible patients not discharged on day of surgery (inpatients) as control group.
Results: Of 2,278 day-case eligible patients, 2,073 (91%) completed the survey, including 1,146 day-case patients (55%) and 927 inpatients (45%). The overall rate of healthcare system contacts was 49% (95% confidence interval [CI] 45–51) in day-case patients compared with 52% (CI 49–56) in inpatients. Specific contacts included visits to a general practitioner (GP) or out-of-hours medical clinic (25% [CI 22–27] vs 32% [CI 29–35]), the emergency department (ED) (6% [CI 4–7] vs 7% [CI 5–8]), and outpatient clinics or wards (35% [CI 33–38] vs 35% [CI 32–38]). The most common reasons for all types of healthcare contacts were wound problems, prescription renewals, and pain management.
Conclusion: Day-case hip and knee arthroplasties was not associated with increased healthcare system contacts within the first 30 days postoperatively.
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Copyright (c) 2025 Abdullahi Abdirisak Hirsi, Oddrún Danielsen, Claus Varnum, Thomas Jakobsen, Mikkel Rathsach Andersen, Manuel Josef Bieder, Søren Overgaard, Christoffer Calov Jørgensen, Henrik Kehlet, Kirill Gromov, Martin Lindberg-Larsen
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