Feasibility, safety, and patient-reported outcomes 90 days after same-day total knee arthroplasty: a matched cohort study

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Background and purpose — Despite increased attention to and acceptance of fast-track procedures, there is a lack of studies concerning discharge on the day of surgery (DOS) following total knee arthroplasty (SD-TKA). We evaluated the feasibility of SD-TKA, and compared safety and patient-reported outcomes (PROs) between patients undergoing SD-TKA and patients undergoing standard TKA. Patients and methods — A SD-TKA group (n = 101) was matched 1:1 to a standard TKA group (n = 101) on age, sex, and ASA score. Feasibility (being discharged on DOS), safety (unplanned contacts and complications evaluated by telephone calls (2 weeks), outpatient visits (2 weeks), and readmission (90 days)) were assessed. Further, Oxford Knee Score (OKS) and Visual Analogue Scale (VAS) (pain at rest and activity) were reported (90 days). Results — 89 of 101 SD-TKA patients were discharged on DOS. The number of telephone calls (≤ 83) and outpatient visits (12) were similar in the 2 groups. The number of read-missions was ≤ 3 in both groups, and only 1 of the readmis-sions was related to TKA surgery. No differences were found at 90-day follow-up in terms of OKS (34 in both groups) or VAS (rest: SD-TKA = 7 and standard TKA = 8; activity: SD-TKA = 17 and standard TKA = 15). Interpretation — SD-TKA is feasible in a selected group of patients, and safety and PROs are comparable to patients undergoing standard TKA.

TidsskriftActa Orthopaedica
Sider (fra-til)509-518
Antal sider10
StatusUdgivet - jun. 2022

Bibliografisk note

Funding Information:
The SIKS database was approved by the Danish Data Protection Agency (1-16-02-935-17), and pre-registered at ClinicalTrials.gov (NCT03411083). Participants gave written informed consent. Central Denmark Region and the hospital management consented to transfer data from the electronic medical record to the SIKS database (1-45-70-70-20) after expiration of informed consent. The Danish Health Data Board provided data from the DNPR (00005469). Data on feasibility, telephone calls, outpatient visits, and PROs from the SIKS database is available from the authors upon reasonable request and with the needed permissions. Data on readmission from the Danish National Patient Registry was provided by the Danish Health Data Board. Restrictions apply to the availability, as the data was used under license for the current study, and so is not publicly available. The study was funded by grants from Fogs Fond; it played no role in the completion of the study or the manuscript. STS is funded by a grant from Region Zealand (Exercise First) and 2 grants from the European Union’s Horizon 2020 research and innovation program (MOBILIZE (No 801790) and ESCAPE (No 945377). All authors declared they had no conflicts of interest.

Publisher Copyright:
© 2022 The Author(s). Published by Medical Journals Sweden, on behalf of the Nordic Orthopedic Federation.

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