Quality of Recovery, Postdischarge Hospital Utilization, and 2-Year Functional Outcomes After an Outpatient Total Knee Arthroplasty Program

Gauthier-Kwan, Olivier Y.; Dobransky, Johanna; Dervin, Geoffrey F.

doi:10.1016/j.arth.2018.01.058

Cited by 33 publications

(33 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 In a more recent prospective comparative cohort study, IP and OP TKA cohorts were found to have similar quality of recovery scores-9, Knee Injury and Osteoarthritis Outcome Scores and Western Ontario and McMaster Universities Osteoarthritis Index subscores at 2 years after surgery. 31 While no significant differences in patient satisfaction have been reported, the observed trends tended to favor OP surgeries. 27,32 Another recent study revealed patients prefer to recover at home, even when they expect a need for more hospital days.…”

Section: Outcomes Of Outpatient Tkamentioning

confidence: 94%

“…No differences in patient-reported outcomes or satisfaction levels or functional outcomes have been demonstrated between in OP versus IP TKA. 20,31 In a prospective study comparing OP and IP TKA cohorts, Kolisek et al reported equivalent Knee Society knee scores, function scores, and range of motion between the cohorts at a mean of 24 months followup. 20 In a more recent prospective comparative cohort study, IP and OP TKA cohorts were found to have similar quality of recovery scores-9, Knee Injury and Osteoarthritis Outcome Scores and Western Ontario and McMaster Universities Osteoarthritis Index subscores at 2 years after surgery.…”

Section: Outcomes Of Outpatient Tkamentioning

confidence: 99%

See 1 more Smart Citation

Inpatient versus Outpatient Total Knee Arthroplasty

et al. 2019

View full text Add to dashboard Cite

The rise of improved perioperative recovery protocols after total knee arthroplasty (TKA) has led to faster, more streamlined hospital stays for many patients. Combined with the implementation of value-based care and bundled payment initiatives, there has been a paradigm shift toward outpatient TKA surgery. This change to practice has been accelerated by recent policy changes enacted by the Center for Medicaid and Medicare Services regarding the removal of TKA as an inpatient only procedure as well as some insurance companies denying preauthorization for inpatient stays after TKA. Our review aims to address the inclusion and exclusion criteria for outpatient TKA consideration, examine the outcomes for outpatient joint replacement surgery, and discuss limitations of widespread adoption for same-day discharges.

show abstract

Section: Outcomes Of Outpatient Tkamentioning

confidence: 94%

Section: Outcomes Of Outpatient Tkamentioning

confidence: 99%

Inpatient versus Outpatient Total Knee Arthroplasty

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Some authors suggested that no differences exist in terms of complication rate between outpatient TKAs and inpatient TKAs. The retrospective studies of Darrith et al [25] on 92 patients (46 outpatients), Cassard et al [24] on 574 patients (61 outpatients), Springer et al [29] on 166 patients (92 outpatients), and Gillis et al [27] on 400 patients (125 outpatients), as well as the prospective comparative cohort study of Gauthier-Kwan et al [26] on 43 outpatients vs 43 inpatients TKAs, reported comparable complication and readmission rates. A comparable readmission rate was also reported by Kimball et al [30] in a retrospective study analyzing 1726 patients (863 outpatients).…”

Section: Discussionmentioning

confidence: 92%

“…Eleven of these studies were excluded after full-text reading for the following reasons: 2 studies had results non-separated from other joints; 7 studies had data coming from the same database of other articles and included a lower number of patients; 1 study reported complications and readmission as odds ratio, 1 study reported data as percentage of subgroups making the results inaccurate for the analysis [22]. For this reasons, only 8 articles were included in the meta-analysis [23][24][25][26][27][28][29][30] (Fig. 1).…”

Section: Review Statisticsmentioning

confidence: 99%

Outpatient total knee arthroplasty leads to a higher number of complications: a meta-analysis

Bordoni¹,

Poggi²,

Zaffagnini³

et al. 2020

J Orthop Surg Res

View full text Add to dashboard Cite

Background Careful pre- and post-operative management can allow surgeons to perform outpatient TKA, making this a more affordable procedure. The aim of the present meta-analysis is to compare outpatient and inpatient TKA. Methods A systematic search of the literature was performed in July 2020 on PubMed, Web of Science, Cochrane library, and on the grey literature databases. The papers collected were used for a meta-analysis comparing outpatient and inpatient TKA in terms of complication and readmission rates. Risk of bias and quality of evidence were defined according to Cochrane guidelines. Results The literature search resulted in 4107 articles; of these, 8 articles were used for the meta-analysis. A total of 212,632 patients were included, 6607 of whom were TKA outpatients. The overall complication rate for outpatient TKAs was 16.1%, while inpatient TKAs had an overall lower complication rate of 10.5% (p = 0.003). The readmission rate was 4.9% in outpatient TKAs and 5.9% in inpatient TKAs. Only 3 studies reported the number of deaths, which accounted for 0%. The included studies presented a moderate risk of bias, and according to GRADE guidelines, the level of evidence for complications and readmissions was very low. Conclusions This meta-analysis documented that outpatient TKA led to an increased number of complications although there were no differences in the number of readmissions. However, future high-level studies are needed to confirm results and indications for the outpatient approach, since the studies currently available have a moderate risk of bias and a very low quality of evidence.

show abstract

“…2 Patients endorsed same-day discharge 87% of the time, 3 and complication r a t e s w e r e c o m p a r a b l e b e t w e e n patients who were discharged the same day and those who remained in hospital. 4,5 Finally, system cost saving was estimated at 32.7%. 6 As Paul Batalden has said, "Every system is perfectly designed to get the outcomes it gets."…”

mentioning

confidence: 99%