Rapid Recovery Is Feasible for Aseptic Revision Total Knee Arthroplasty at an Academic Medical Center

Same-Day Discharge Following Aseptic Revision and Conversion Total Joint Arthroplasty: A Single-Institution Experience

“…Nineteen percent (4 patients) had an unplanned ED visit, and 9.5% (2 patients) were readmitted within 90 days of discharge, which did not statistically differ compared to patients undergoing nonrapid recovery aseptic rTJA. Although it is important to note that the Buller et al [23] and Pontasch et al [24] studies do not provide direct evidence for SDD, they support feasible transition of appropriate aseptic rTJA surgeries to the outpatient setting.…”

“…[ 23 ] and Pontasch et al. [ 24 ] studies do not provide direct evidence for SDD, they support feasible transition of appropriate aseptic rTJA surgeries to the outpatient setting.…”

“…More recently, Pontasch et al. [ 24 ] investigated a single surgeon cohort of 33 aseptic rTKAs with full component exchange performed in an academic center with modern rapid recovery protocols and a goal of discharge by 11 AM on POD 1. Sixty-four percent of patients achieved this goal with an average stay of 22 hours.…”

“…In a matched cohort of 183 same-or next-day discharge and 183 later-discharge patients, Buller et al [23] found no differences in 90-day ED visits (3.4% vs 6.7%, respectively) or hospital readmission rates (3.9% vs 2.4%, respectively). More recently, Pontasch et al [24] investigated a single surgeon cohort of 33 aseptic rTKAs with full component exchange performed in an academic center with modern rapid recovery protocols and a goal of discharge by 11 AM on POD 1. Sixty-four percent of patients achieved this goal with an average stay of 22 hours.…”

“…Outpatient primary TJA has been adopted at a growing number of ambulatory surgical centers (ASCs) and hospital systems in the United States. Studies have demonstrated that with appropriate risk stratification and patient selection, and modern arthroplasty care pathways and perioperative protocols, outpatient primary TJA has outcomes equivalent or superior to inpatient primary TJA [ [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] ] More recently, early discharge following aseptic revision TJA has been investigated; however, only a few studies have been published to date, [ [21] , [22] , [23] , [24] ] with only 2 studies focused specifically on same-day discharge (SDD) [ 21 , 22 ]. As the trend toward outpatient primary and aseptic revision TJA accelerates, futher investigation is required to identify patient selection criteria and best perioperative practices to ensure patient safety.…”