Day of Surgery Discharge after Unicompartmental Knee Arthroplasty: An Effective Perioperative Pathway
Section snippets
Materials and Methods
We prospectively collected data on 207 consecutive patients who underwent UKA at an outpatient surgical center between January 2003 and February 2013. Data for all patients with a minimum follow-up of 60 days were analyzed after obtaining local IRB approval. In May 2008 we transitioned from planned overnight stay to discharge on the DOS. Thus, the total group of 207 patients consists of two cohorts, one pre-transition with planned overnight stay (n = 47) and a second post-transition with planned
Results
During the study period 207 UKAs were performed on 186 patients by two surgeons (SB and RG). Over the same study period 3,992 TKA were performed by these two surgeons. UKA made up 4.95% of their knee arthroplasty volume. Of the 207 UKAs, forty-seven surgeries had planned one-night admission prior to the May 2008 transition to planned discharge on the day of surgery (DOS). After the transition, 160 patients underwent UKA with planned discharge on the DOS. All patients with planned DOS discharge
Discussion
This study presents our experience with outpatient UKA over the past decade. In 2008 we began DOS discharge of carefully selected patients. Using a simple perioperative pathway we have successfully completed day of surgery discharge in 160 consecutive patients. One of those patients had an overnight emergency room admission after discharge for drainage from a drain site which resolved without incident. Analysis of our outcomes data revealed very few perioperative complications, with excellent
Acknowledgments
The authors would like to thank Dr. Michael Patzakis, Ryan Mayer (MS2) and Susie Porter (NP) for their help with manuscript preparation.
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The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.08.021.