Background: Most patients who have an ankle replacement in the United Kingdom stay in hospital for 2-4 days. This study looked at the safety & cost-effectiveness of a day case ankle replacement pathway. Methods: This was a retrospective case-control study looking at day case pathway for ankle replacements set up in collaboration with anaesthetists, nurses and physiotherapists. Patients practiced mobilization with crutches before surgery. Patients were discharged home with enough analgesia, and reviewed within 2-5 days of discharge. Results: Twenty ankle replacements done between November 2017 and November 2019 were reviewed with a mean follow up of 38.4 months. None of these patients required to be readmitted within the first 28 days. No complications were related to the surgery being done as day case. Except one, all patients described the experience as excellent or good. Conclusion: Per case the cost savings are estimated to be £880 in comparison to 20 matched inpatient ankle replacements. We conclude that ankle replacements can be safely carried out as day case with appropriate patient selection, pre-operative education and a multi-disciplinary approach.
Background: Most patients who have an ankle replacement in the United Kingdom stay in hospital for 2-4 days. This study looked at the safety & cost-effectiveness of a day case ankle replacement pathway. Methods: This was a retrospective case-control study looking at day case pathway for ankle replacements set up in collaboration with anaesthetists, nurses and physiotherapists. Patients practiced mobilization with crutches before surgery. Patients were discharged home with enough analgesia, and reviewed within 2-5 days of discharge. Results: Twenty ankle replacements done between November 2017 and November 2019 were reviewed with a mean follow up of 38.4 months. None of these patients required to be readmitted within the first 28 days. No complications were related to the surgery being done as day case. Except one, all patients described the experience as excellent or good. Conclusion: Per case the cost savings are estimated to be £880 in comparison to 20 matched inpatient ankle replacements. We conclude that ankle replacements can be safely carried out as day case with appropriate patient selection, pre-operative education and a multi-disciplinary approach.
Authors: C R Bailey; M Ahuja; K Bartholomew; S Bew; L Forbes; A Lipp; J Montgomery; K Russon; O Potparic; M Stocker Journal: Anaesthesia Date: 2019-04-08 Impact factor: 6.955
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