Outpatient unicompartmental knee arthroplasty: who is afraid of outpatient surgery?

Hoorntje, Alexander; Koenraadt, Koen L. M.; Boevé, Margreet G.; Geenen, Rutger C. I. van

doi:10.1007/s00167-017-4440-y

Cited by 50 publications

(39 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 2017 , Hoorntje et al. 2017 ). Fast-track TKR is not associated with higher readmission, reoperation, manipulations under anesthesia (MUA) or mortality rates (Husted et al.…”

mentioning

confidence: 99%

Fast-tracking for total knee replacement reduces use of institutional care without compromising quality

et al. 2017

View full text Add to dashboard Cite

Background and purposeFast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR.Patients and methods4,256 TKRs performed in 4 hospitals between 2009–2010 and 2012–2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D). We analyzed length of uninterrupted institutional care (LUIC), LOS, discharge destination, readmission, revision, manipulation under anesthesia (MUA) and mortality rate in each hospital. We compared these outcomes for TKRs performed in Hospital A before and after fast-track implementation and we also compared Hospital A outcomes with the corresponding outcomes for the other 3 hospitals.ResultsAfter fast-track implementation, median LOS in Hospital A fell from 5 to 3 days (p < 0.001) and (median) LUIC from 7 to 3 (p < 0.001) days. These reductions in LOS and LUIC were accompanied by an increase in the discharge rate to home (p = 0.01). Fast-tracking in Hospital A led to no increase in 14- and 42-day readmissions, MUA, revision or mortality compared with the rates before fast-tracking, or with those in the other hospitals. Of the 4 hospitals, LOS and LUIC were most reduced in Hospital A.InterpretationA fast-track protocol reduces LUIC and LOS after TKR without increasing readmission, complication or revision rates.

show abstract

“… 2017 , Hoorntje et al. 2017 ). Fast-track TKR is not associated with higher readmission, reoperation, manipulations under anesthesia (MUA) or mortality rates (Husted et al.…”

mentioning

confidence: 99%

Fast-tracking for total knee replacement reduces use of institutional care without compromising quality

et al. 2017

View full text Add to dashboard Cite

show abstract

“…A welldesigned OTJA program provides safe surgical care with equivalent patient-reported outcomes, such as anxiety, depression, satisfaction, and pain, compared to standard "fast track patients" that require a 1-day hospitalization [30,31]. Furthermore, OTJA programs generate cost savings by improving OR efficiency via surgeon-specific instrumentation and online training tools and improving post-anesthesia care and pain control.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Total Joint Arthroplasty

Bert¹,

Hooper

Moen

2017

Curr Rev Musculoskelet Med

115

View full text Add to dashboard Cite

Purpose of Review Outpatient total joint arthroplasty (OTJA) allows for a safe, cost effective pathway for appropriately selected patients. With current pressures on arthroplasty surgeons and their associated institutions to reduce costs per episode of care, it is important to define the steps and challenges associated with establishing an outpatient arthroplasty program. Recent Findings Several studies have outlined techniques of selecting patients suitable for this type of postoperative pathway. With emerging concerns about patients who undergo outpatient arthroplasty being at increased risk of medical complications, which may lessen projected cost savings, it is important to identify value-based strategies to optimize patient recovery after OTJA. Summary This article reviews digital techniques for patient selection and data collection, operating room efficiency systems, and provides a summary of methods to build and maintain value in outpatient total joint replacement within the framework of bundled payment reimbursement.

show abstract

“…Besides, the results of Larson et al were found after TKA in an enhanced recovery pathway [11,20,21], data after outpatient surgery are lacking. Hoorntje et al [12] recently published their case-controlled study regarding the presence of symptoms of anxiety and depression, by means of the Hospital Anxiety and Depression Scale (HADS) in patients operated after UKA. They found that at the first postoperative day, the median HADS score was significantly (p=0.02) lower in the OS group compared to the ERP group and that patients in the OS group were significantly more satisfied (NRS satisfaction score, p=0.03) without any differences between both groups at 3-month follow-up [12] Pain relief and improved function are one of the principal aims of arthroplasty, thus it was expected that PROMs would improve significantly after knee arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

“…All disciplines should be informed about, and involved in the whole process. Together with well-defined patient-based selection criteria, a change in mind set and a multidisciplinary approach, OS pathways are as safe and efficient as conventional pathways, in terms of readmissions, complications [8,14] and clinical outcome [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…Results have shown that quality of life after TKA, significantly improved within one year postoperative [11]. Although, these results were found after TKA in an enhanced recovery pathway, results during the early postoperative phase have shown that patients following the outpatient joint arthroplasty pathway were satisfied with sufficient physical activity [8,12,13]. Data on the quality of life after outpatient surgery on the long term are lacking.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Improved Health-Related Quality of Life after Knee Arthroplasty Following an Outpatient Surgery Pathway: an Observational Comparative Case Study

Schotanus¹,

Bemelmans²,

Kort³

2017

J Clin Trial

View full text Add to dashboard Cite

Purpose: Enhanced recovery pathways after knee arthroplasty have been introduced worldwide with positive results. The present study investigated the improvements of health-related quality of life and functional outcome in patients operated for knee arthroplasty who followed an Outpatient Surgery (OS) or Enhanced Recovery (ER) pathway. Methods:We reviewed our institutional database of 361 consecutive patients undergoing knee arthroplasty (total and partial) who followed either the OS-pathway (n=94; 26.1%) or ER-pathway (n=267; 73.9%). Recorded outcomes included 4 different patient reported outcome measures (PROMs; EuroQol-5D (both index and VAS), Oxford Knee Score, Western Ontario and McMaster Universities Arthritis Index and the Pain-Numerical Rating Scale) obtained pre-and during the 3-and 12-months postoperative follow-up.Results: 93 patients (99%) in the OS-group were discharged on the day of surgery as scheduled, whereas in the ER-group 70% of the patients were discharged<3 days postoperatively. At 12-month follow-up, the EQ-5D (both index and VAS) and other PROMs improved significantly (p<0.000) within each pathway. There were no significant differences between both pathways. Conclusion:One year after knee arthroplasty, patients who were included in an Outpatient Surgery pathway had comparable quality of life and PROMs as patients operated in an Enhanced Recovery pathway. Level of evidence:Case control study, Level III.

show abstract

Outpatient unicompartmental knee arthroplasty: who is afraid of outpatient surgery?

Cited by 50 publications

References 28 publications

Fast-tracking for total knee replacement reduces use of institutional care without compromising quality

Fast-tracking for total knee replacement reduces use of institutional care without compromising quality

Outpatient Total Joint Arthroplasty

Improved Health-Related Quality of Life after Knee Arthroplasty Following an Outpatient Surgery Pathway: an Observational Comparative Case Study

Contact Info

Product

Resources

About