Short-term outcomes of outpatient surgery for total knee arthroplasty

Singapore Med J. 2019 Jun;60(6):314-316. doi: 10.11622/smedj.2018157. Epub 2018 Dec 17.

Abstract

Introduction: We developed an accelerated clinical pathway involving outpatient surgery for patients undergoing total knee arthroplasty (TKA) who are healthy enough for early discharge.

Methods: Between March 2014 and April 2015, 89 TKAs were performed at a single institution by a single orthopaedic surgeon. 31 patients met the inclusion criteria for the study. All patients received 2 g tranexamic acid and 750 mg cefuroxime sodium intravenously 30 minutes prior to surgery. A multimodal protocol for perioperative pain management was used for all patients.

Results: 31 patients (three male, 28 female), with a mean age of 67 (range 49-78) years, who underwent TKA were enrolled in this study. The mean length of hospital stay was 28.7 (range 16-49) hours and mean duration of surgery was 92 (range 75-128) minutes. Combined spinal epidural anaesthesia was performed for 23 (74.2%) patients and general anaesthesia was used in 8 (25.8%) patients. Among the 31 patients, 23 (74.2%) patients were discharged within 23 hours of surgery.

Conclusion: Early discharge of patients following outpatient surgery for TKA was not associated with any procedure-related complications among the selected patients up to three months postoperatively.

Keywords: knee; rehabilitation; short-term; total knee arthroplasty.

MeSH terms

  • Aged
  • Ambulatory Surgical Procedures* / methods
  • Arthroplasty, Replacement, Knee* / methods
  • Arthroplasty, Replacement, Knee* / rehabilitation
  • Critical Pathways
  • Early Ambulation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Treatment Outcome