Is outpatient joint arthroplasty safe in a high volume academic centre? A retrospective monocentric study using an institutional pathway.

IF 2 3区医学 Q2 ORTHOPEDICS International Orthopaedics Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI:10.1007/s00264-024-06333-y

Gérald Delfosse, Guillaume Mesnard, Martin Ecki, Cécile Batailler, Elvire Servien, Sébastien Lustig

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Abstract

Purpose: Hip and knee arthroplasties are daily procedures in orthopaedic departments. Recently, same-day discharge (SDD) became increasingly popular, but doubts remain about its safety and generalization. Our hypothesis is that outpatient arthroplasty, in a high volume centre and with an institutional protocol, is an effective and reliable practice.

Methods: We realized a monocentric retrospective study of patients undergoing outpatient partial (UKA) or total (TKA) knee or hip arthroplasty (THA) in a high volume academic centre using a well-defined institutional pathway. Epidemiological data and complications occurring in the month following surgery were studied.

Results: 498 patients undergoing 501 arthroplasties (219 hips and 282 knees) were examined. The percentage of men and women was 60.28% and 39.72% respectively, mean age was 64.56 ± 9.59 years, mean BMI was 26.87 ± 4.2 and the most represented ASA score was 2. The success rate for same-day discharge was 97.21%. The most frequent causes of failure were urinary retention (28.6%), orthostatic hypotension (28.6%) and insufficiently controlled pain (14.3%). The readmission rate in the month following the operation was 0.8% and the rate of emergency department visits was 1.6%. Finally, the rate of early consultation visits was 7.98%. The comparison between success and failure subgroups in the outpatient setting of our cohort did not highlight statistically significant differences for studied parameters.

Conclusion: Outpatient arthroplasty, performed in a center used to managing such operations and with a well-established institutional pre- and post-operative protocol, is a safe practice.

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高流量学术中心的门诊关节置换术安全吗？利用机构路径进行的单中心回顾性研究。

目的：髋关节和膝关节置换术是骨科的日常手术。最近，当日出院（SDD）越来越流行，但其安全性和普及性仍存在疑问。我们的假设是，在一个高手术量的中心，按照机构规定进行门诊关节置换术是一种有效、可靠的做法：方法：我们对在一家高流量学术中心接受门诊部分（UKA）或全（TKA）膝关节或髋关节置换术（THA）的患者进行了一项单中心回顾性研究，该研究采用了明确的机构路径。对流行病学数据和术后一个月内发生的并发症进行了研究：共对 498 名患者进行了 501 例关节置换术（219 例髋关节置换术和 282 例膝关节置换术）。男性和女性的比例分别为 60.28% 和 39.72%，平均年龄为（64.56±9.59）岁，平均体重指数为（26.87±4.2），最有代表性的 ASA 评分为 2 分。最常见的失败原因是尿潴留（28.6%）、正性低血压（28.6%）和疼痛未得到充分控制（14.3%）。术后一个月内的再入院率为 0.8%，急诊就诊率为 1.6%。最后，早期就诊率为 7.98%。在我们的队列中，成功和失败亚组在门诊环境下的比较并未显示出所研究参数在统计学上的显著差异：结论：门诊关节置换术在习惯于管理此类手术的中心进行，并有完善的机构术前术后方案，是一种安全的做法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Orthopaedics 医学-整形外科

CiteScore

5.50

自引率

7.40%

发文量

360

审稿时长

1 months

期刊介绍： International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters. Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable. The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.