Outpatient Arthroplasty Is Associated With More Complications

Outpatient total knee arthroplasty (TKA) is associated with more medical and surgical complications compared with inpatient TKA, according to the findings of a recent study.

For their retrospective review, the researchers identified 4391 patients who underwent outpatient TKA and 128,951 patients who underwent inpatient TKA from 2007 to 2015 from the Humana subset of the PearlDiver Patient Record Database. They determined the incidence of perioperative medical and surgical complications and calculated the odds ratios for each complication.
​_________________________________________________________________________
RELATED CONTENT
Risk Factors for Prosthetic Joint Infection Following Total Hip, Knee Arthroplasty
Does Obesity Hinder Pain Relief Following Total Joint Replacement?
_________________________________________________________________________

After adjusting for age, sex, and Charlson Comorbidity Index, the researchers found that outpatient TKA was more frequently associated with tibial and/or femoral component revision due to a noninfectious cause, explanation of the prosthesis, irrigation and debridement, and stiffness requiring manipulation under anesthesia within 1 year post-surgery.

In addition, outpatient TKA was associated with more postoperative deep vein thrombosis and acute renal failure compared with inpatient TKA.

“Surgeons and health-care administrators who wish to implement outpatient arthroplasty should consider complication rates and adapt rigorous and comprehensive clinical pathways to carefully select and treat patients,” the researchers concluded.

—Melissa Weiss

Reference:

Arshi A, Leong NL, D’Oro A, et al. Outpatient total knee arthroplasty is associated with higher risk of perioperative complications. JBJS. 2017;99(23):1978-1986. doi:10.2106/JBJS.16.01332.