Short-term outcomes of outpatient surgery for total knee arthroplasty

• Published in: Singapore medical journal Vol. 60; no. 6; pp. 314 - 316
• Main Authors: Bilgen, Muhammet Sadık, Yaray, Osman, Mutlu, Müren, Çakır, Ahmet İdris, Bilgen, Ömer Faruk
• Format: Journal Article
• Language: English
• Published: Singapore Singapore Medical Association 01-06-2019
• Subjects: Aged; Ambulatory Surgical Procedures - methods; Arthroplasty, Replacement, Knee - methods; Arthroplasty, Replacement, Knee - rehabilitation; Critical Pathways; Early Ambulation; Female; Humans; Male; Middle Aged; Original; Treatment Outcome; knee; total knee arthroplasty; rehabilitation; short-term
• ISSN: 0037-5675
• DOI: 10.11622/smedj.2018157

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