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Greater risk of perioperative complications seen with outpatient TKA
Results from this study demonstrated patients who underwent outpatient total knee arthroplasty had a greater risk for perioperative complications compared with patients who had inpatient total knee arthroplasty.
“Given the low absolute rates of complications in both groups, it is likely that outpatient TKA will emerge as a safe option in the setting of postoperative care pathways that insure equivalent attention to rehabilitation, antibiotic and thromboprophylaxis as current inpatient protocols,” Nelson F. SooHoo, MD, told Healio.com/Orthopedics.
Researchers performed a retrospective review of the Humana subset of the PearlDiver Patient Record Database and identified 4,391 patients who underwent outpatient TKA and 128,951 patients who underwent inpatient TKA. International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes were used to determine the incidence of perioperative medical and surgical complications. Odds ratios of complications among the outpatient group relative to the inpatient group were calculated with multivariable logistic regression analysis, which was adjusted for age, sex and Charlson Comorbidity Index.
Across the study period, investigators found an increase in the incidence of outpatient TKA. Investigators noted outpatient TKAs were more likely to lead to tibial and/or femoral component revision from a noninfectious cause, explantation of the prosthesis, irrigation and debridement, and stiffness necessitating manipulation under anesthesia. There was a correlation between outpatient TKA and postoperative deep vein thrombosis and acute renal failure. – by Monica Jaramillo
Disclosures: Arshi reports more relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.