BACKGROUND: Although some prior work supports the safety of same-day arthroplasty performed in a hospital, concerns remain when these procedures are performed in a free-standing ambulatory surgery center. The purpose of this study is to compare 90-day complication rates between matched cohorts that underwent inpatient vs outpatient arthroplasty at an ambulatory surgery center. METHODS: A single-surgeon cohort of 243 consecutive patients who underwent outpatient arthroplasty was matched with 243 inpatients who had the same procedure. One-to-one nearest-neighbor matching with respect to gender, age, American Society of Anesthesiologists Score, and body mass index was utilized. The 486 primary arthroplasties included 178 unicondylar knees (36.6%), 146 total hips (30.0%), 92 total knees (18.9%), and 70 hip resurfacings (14.5%). Ninety-day outcomes including reoperation, readmission, unplanned clinic or emergency department visits, and major and minor complications were compared using a 2-sample proportions test. RESULTS: The 2 cohorts were similar in distribution of demographic variables, demonstrating successful matching. The inpatient and outpatient cohorts both had readmission rates of 2.1% (P = 1.0). With the number of subjects studied, there were no statistically significant differences in rates of major complications (2.1% vs 2.5%, P = 1.0), minor complications (7.0% vs 7.8%, P = .86), reoperations (0.4% vs 2.1%, P = .22), emergency department visits (1.6% vs 2.5%, P = .52), or unplanned clinic visits (3.3% vs 5.8%, P = .19). CONCLUSION: This study suggests that arthroplasty procedures can be performed safely in an ambulatory surgery center among appropriately selected patients without an increased risk of complications.
BACKGROUND: Although some prior work supports the safety of same-day arthroplasty performed in a hospital, concerns remain when these procedures are performed in a free-standing ambulatory surgery center. The purpose of this study is to compare 90-day complication rates between matched cohorts that underwent inpatient vs outpatient arthroplasty at an ambulatory surgery center. METHODS: A single-surgeon cohort of 243 consecutive patients who underwent outpatient arthroplasty was matched with 243 inpatients who had the same procedure. One-to-one nearest-neighbor matching with respect to gender, age, American Society of Anesthesiologists Score, and body mass index was utilized. The 486 primary arthroplasties included 178 unicondylar knees (36.6%), 146 total hips (30.0%), 92 total knees (18.9%), and 70 hip resurfacings (14.5%). Ninety-day outcomes including reoperation, readmission, unplanned clinic or emergency department visits, and major and minor complications were compared using a 2-sample proportions test. RESULTS: The 2 cohorts were similar in distribution of demographic variables, demonstrating successful matching. The inpatient and outpatient cohorts both had readmission rates of 2.1% (P = 1.0). With the number of subjects studied, there were no statistically significant differences in rates of major complications (2.1% vs 2.5%, P = 1.0), minor complications (7.0% vs 7.8%, P = .86), reoperations (0.4% vs 2.1%, P = .22), emergency department visits (1.6% vs 2.5%, P = .52), or unplanned clinic visits (3.3% vs 5.8%, P = .19). CONCLUSION: This study suggests that arthroplasty procedures can be performed safely in an ambulatory surgery center among appropriately selected patients without an increased risk of complications.
Authors: David A Crawford; Joanne B Adams; Keith R Berend; Adolph V Lombardi Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-05-18 Impact factor: 4.342
Authors: Drake G LeBrun; Scott M LaValva; Bradford S Waddell; David J Mayman; Seth A Jerabek; Michael M Alexiades; Michael P Ast Journal: HSS J Date: 2021-11-08
Authors: Tarik Bayoumi; Jelle P van der List; Lindsey V Ruderman; Hendrik A Zuiderbaan; Gino M M J Kerkhoffs; Andrew D Pearle Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-08-11 Impact factor: 4.114
Authors: Benjamin R Williams; Lauren C Smith; Arthur J Only; Harsh R Parikh; Marc F Swiontkowski; Brian P Cunningham Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2021-09-20
Authors: Y F L Bemelmans; M H F Keulen; M Heymans; E H van Haaren; B Boonen; M G M Schotanus Journal: Arch Orthop Trauma Surg Date: 2021-02-15 Impact factor: 2.928
Authors: Justin J Turcotte; Nandakumar Menon; McKayla E Kelly; Jennifer J Grover; Paul J King; James H MacDonald Journal: Arthroplast Today Date: 2021-02-01