Outpatient UKA associated with lower risk of complications compared with inpatient UKA
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Contrary to data from prior years, data from 2016 to 2018 shows outpatient unicompartmental knee arthroplasty is independently associated with lower rates of complications compared with inpatient unicompartmental knee arthroplasty.
In a recently published study, Edward S. Hur, MD, and colleagues from the department of orthopaedic surgery at Rush University Medical Center used the National Surgical Quality Improvement Program to compare an early cohort of 5,555 patients who underwent unicompartmental knee arthroplasty (UKA) from 2005 to 2015 and a late cohort of 5,627 patients who underwent UKA from 2016 to 2018. Researchers examined 30-day postoperative complications in both cohorts for outpatient vs. inpatient UKA. They also evaluated changes over time, as outpatient procedures were performed more frequently, according to the study.
In the early cohort, inpatient UKA had lower rates of surgical site infection compared with outpatient UKA (0.84% vs. 1.69%). However, in the late cohort, inpatient UKA had higher rates of any complication compared with outpatient UKA (2.53% vs. 0.95%) and higher rates of readmission (1.81% vs. 0.88%).
“There was a significant reduction in the overall rate of complications over time (3.44% in the early cohort compared with 2.11% in the late cohort), with a more than fourfold reduction among outpatients (3.95% in the early cohort compared with 0.95% in the late cohort),” the researchers wrote in the study.
“The present study confirms that the proportion of UKAs performed as an outpatient procedure has risen dramatically and that the complication rate has decreased precipitously,” they added. “This shift may represent changes in patient selection or improvements in perioperative protocols,” they concluded.
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