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Published in: International Orthopaedics 2/2014

01-02-2014 | Original Paper

Feasibility and safety of performing outpatient unicompartmental knee arthroplasty

Authors: Michael B. Cross, Richard Berger

Published in: International Orthopaedics | Issue 2/2014

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Abstract

Purpose

Unicompartmental knee arthroplasty (UKA) has a faster short-term recovery than total knee arthroplasty (TKA). The purpose of this study was to determine the feasibility and safety of performing outpatient UKAs in a consecutive group of patients presenting with unicompartmental knee osteoarthritis.

Methods

A total of 105 consecutive patients underwent unicompartmental arthroplasty before noon with the intention of being discharged as an outpatient. All patients followed an established rapid recovery pathway to facilitate a same-day discharge. Post-operative complications and hospital readmissions were retrospectively recorded for all patients at one week and at three months after surgery.

Results

All of the 105 patients (100 %) indicated for outpatient UKA could be discharged home on the same day of surgery. No patients required readmission within the first week post-operatively, while one patient required readmission between week one and week 12. The single patient who required readmission developed a post-operative infection requiring irrigation/debridement with polyethylene liner exchange and intravenous antibiotics.

Conclusion

Using an established, multidisciplinary, rapid recovery protocol, outpatient UKA is safe and feasible in the vast majority of patients.
Literature
1.
go back to reference Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, Della Valle CJ (2012) Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J Arthroplasty 27(8 Suppl):86–90. doi:10.1016/j.arth.2012.03.022 PubMedCrossRef Brown NM, Sheth NP, Davis K, Berend ME, Lombardi AV, Berend KR, Della Valle CJ (2012) Total knee arthroplasty has higher postoperative morbidity than unicompartmental knee arthroplasty: a multicenter analysis. J Arthroplasty 27(8 Suppl):86–90. doi:10.​1016/​j.​arth.​2012.​03.​022 PubMedCrossRef
4.
go back to reference Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C (2009) Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop Relat Res 467(6):1424–1430PubMedCrossRef Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C (2009) Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop Relat Res 467(6):1424–1430PubMedCrossRef
5.
go back to reference Mason JB (2008) The new demands by patients in the modern era of total joint arthroplasty: a point of view. Clin Orthop Relat Res 466(1):146–152PubMedCrossRef Mason JB (2008) The new demands by patients in the modern era of total joint arthroplasty: a point of view. Clin Orthop Relat Res 466(1):146–152PubMedCrossRef
6.
go back to reference Booth RE Jr (2006) Truth in advertising: the ethical limits of direct-to-consumer marketing. Orthopedics 29:780–781PubMed Booth RE Jr (2006) Truth in advertising: the ethical limits of direct-to-consumer marketing. Orthopedics 29:780–781PubMed
7.
go back to reference Bozic KJ, Smith AR, Hariri S, Adeoye O, Gourville J, Maloney WJ, Parsley B, Rubash HE (2007) The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics. Clin Orthop Relat Res 458:202–219PubMed Bozic KJ, Smith AR, Hariri S, Adeoye O, Gourville J, Maloney WJ, Parsley B, Rubash HE (2007) The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics. Clin Orthop Relat Res 458:202–219PubMed
8.
go back to reference Cleary PD, Greenfield S, Mulley AG, Pauker SG, Schroeder SA, Wexler L, McNeil B (1991) Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California. JAMA 266:73–79PubMedCrossRef Cleary PD, Greenfield S, Mulley AG, Pauker SG, Schroeder SA, Wexler L, McNeil B (1991) Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California. JAMA 266:73–79PubMedCrossRef
9.
go back to reference Kim S, Losina E, Solomon DH, Wright J, Katz JN (2003) Effectiveness of clinical pathways for total knee and total hip arthroplasty: literature review. J Arthroplasty 18:69–74PubMedCrossRef Kim S, Losina E, Solomon DH, Wright J, Katz JN (2003) Effectiveness of clinical pathways for total knee and total hip arthroplasty: literature review. J Arthroplasty 18:69–74PubMedCrossRef
10.
go back to reference Mabrey JD, Toohey JS, Armstrong DA, Lavery L, Wammack LA (1997) Clinical pathway management of total knee arthroplasty. Clin Orthop Relat Res 345:125–133PubMedCrossRef Mabrey JD, Toohey JS, Armstrong DA, Lavery L, Wammack LA (1997) Clinical pathway management of total knee arthroplasty. Clin Orthop Relat Res 345:125–133PubMedCrossRef
11.
go back to reference Healy WL, Iorio R, Ko J, Appleby D, Lemos DW (2002) Impact of cost reduction programs on short-term patient outcome and hospital cost of total knee arthroplasty. J Bone Joint Surg Am 84:348–353PubMed Healy WL, Iorio R, Ko J, Appleby D, Lemos DW (2002) Impact of cost reduction programs on short-term patient outcome and hospital cost of total knee arthroplasty. J Bone Joint Surg Am 84:348–353PubMed
12.
go back to reference Mauerhan DR, Mokris JG, Ly A, Kiebzak GM (1998) Relationship between length of stay and manipulation rate after total knee arthroplasty. J Arthroplasty 13:896–900PubMedCrossRef Mauerhan DR, Mokris JG, Ly A, Kiebzak GM (1998) Relationship between length of stay and manipulation rate after total knee arthroplasty. J Arthroplasty 13:896–900PubMedCrossRef
13.
go back to reference Pearson S, Moraw I, Maddern GJ (2000) Clinical pathway management of total knee arthroplasty: a retrospective comparative study. Aust N Z J Surg 70:351–354PubMedCrossRef Pearson S, Moraw I, Maddern GJ (2000) Clinical pathway management of total knee arthroplasty: a retrospective comparative study. Aust N Z J Surg 70:351–354PubMedCrossRef
14.
15.
go back to reference Perry JE (2012) Physician-owned specialty hospitals and the Patient Protection and Affordable Care Act: health care reform at the intersection of law and ethics. Am Bus Law 49:369–416CrossRef Perry JE (2012) Physician-owned specialty hospitals and the Patient Protection and Affordable Care Act: health care reform at the intersection of law and ethics. Am Bus Law 49:369–416CrossRef
16.
go back to reference Berger RA, Sanders S, D’Ambrogio E, Buchheit K, Deirmengian C, Paprosky W, Della Valle CJ, Rosenberg AG (2006) Minimally invasive quadriceps-sparing TKA: results of a comprehensive pathway for outpatient TKA. J Knee Surg 19:145–148PubMed Berger RA, Sanders S, D’Ambrogio E, Buchheit K, Deirmengian C, Paprosky W, Della Valle CJ, Rosenberg AG (2006) Minimally invasive quadriceps-sparing TKA: results of a comprehensive pathway for outpatient TKA. J Knee Surg 19:145–148PubMed
17.
go back to reference Berger RA, Sanders S, Gerlinger T, Della Valle C, Jacobs JJ, Rosenberg AG (2005) Outpatient total knee arthroplasty with a minimally invasive technique. J Arthroplasty 20:33–38PubMedCrossRef Berger RA, Sanders S, Gerlinger T, Della Valle C, Jacobs JJ, Rosenberg AG (2005) Outpatient total knee arthroplasty with a minimally invasive technique. J Arthroplasty 20:33–38PubMedCrossRef
Metadata
Title
Feasibility and safety of performing outpatient unicompartmental knee arthroplasty
Authors
Michael B. Cross
Richard Berger
Publication date
01-02-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 2/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-013-2214-9

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Acknowledgement to referees