Unicompartmental Knee Arthroplasty Is Cost-Effective in an Outpatient Setting

Abstract

Introduction: Increasingly, unicompartmental knee arthroplasty (UKA) is being performed on an outpatient basis, with the growing utilization of ambulatory surgery centers (ASCs). The purpose of this study was to compare the costs of UKAs performed in an ASC to UKAs done in a hospital, either on an outpatient or inpatient basis.Methods: This study involved three matched groups, each with 50 consecutive patients, undergoing UKA either on an outpatient basis in an ASC or a community hospital, or who were admitted overnight to the same community hospital. Identical perioperative analgesic regimens and care protocols were used in each group. The primary outcomes evaluated included direct facility costs. Secondary outcomes were postoperative complications and readmissions.Results: Average age, gender ratio, and comorbidities were similar in all three cohorts. Only two patients in the study experienced complications and these were without secondary adverse consequences. Mean costs were substantially reduced when UKAs were performed in an ASC ($9,025) compared to a community hospital on either an outpatient ($12,032) or inpatient basis ($14,542).Conclusion: UKA can be safely performed in the outpatient setting, in appropriately selected patients, at substantial cost savings, particularly when performed in an ASC.

Evaluation of Costs Associated With Acute Achilles Tendon Repair

“… 7 Lower costs in ambulatory surgery centers have also been seen for total ankle arthroplasties, 8 total hip arthroplasty, 20 and unicompartmental knee arthroplasty. 6 Similarly, carpal tunnel release surgery in a procedure room setting minimized direct surgical encounter costs relative to an operating room. 11 In agreement with this, our study showed that direct costs were reduced by 19% to 25% and facility costs by 41% to 44% when performed at an ambulatory surgery center vs a University hospital setting.…”