Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes?
Background: This study compared outcomes between patients undergoing outpatient total joint arthroplasty (TJA) at an ambulatory surgery center (ASC) versus a cohort of medically and socially complex patients undergoing TJA at a tertiary healthcare system. Methods: An institutional database at a sing...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-04-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344125000184 |
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| author | Justin Leal, BS Christine J. Wu, MD Niall H. Cochrane, MD Thorsten M. Seyler, MD, PhD William A. Jiranek, MD Samuel S. Wellman, MD Michael P. Bolognesi, MD Sean P. Ryan, MD |
| author_facet | Justin Leal, BS Christine J. Wu, MD Niall H. Cochrane, MD Thorsten M. Seyler, MD, PhD William A. Jiranek, MD Samuel S. Wellman, MD Michael P. Bolognesi, MD Sean P. Ryan, MD |
| author_sort | Justin Leal, BS |
| collection | DOAJ |
| description | Background: This study compared outcomes between patients undergoing outpatient total joint arthroplasty (TJA) at an ambulatory surgery center (ASC) versus a cohort of medically and socially complex patients undergoing TJA at a tertiary healthcare system. Methods: An institutional database at a single academic center was retrospectively reviewed for patients who underwent primary TJA since the opening of an ASC from August 2021 to January 2024. A total of 716 (outpatient: 374; inpatient: 342) total knee arthroplasties and 458 (outpatient: 196; inpatient: 262) total hip arthroplasties met inclusion criteria. Results: Patients in the inpatient total knee arthroplasty group had a higher proportion of patients requiring an emergency department visit (11.4% vs 4.5%; P = .008) and admission (6.7% vs 2.7%; P = .025) within the first 90 days after surgery than the outpatient group; however, 2-year revision-free (97.9% vs 97.9%; P = .75) survival was similar between groups. Patients in the inpatient total hip arthroplasty group had a higher proportion of patients requiring an emergency department visit (13.0% vs 4.6%; P = .035) and admission (7.3% vs 1.0%; P = .018) within the first 90 days after surgery compared to the outpatient group; however, there was no difference in 2-year revision-free survival (96.4% vs 99.5%; P = .059). Conclusions: Medically and socially complex patients undergoing TJA required additional resources during the 90-day postoperative window; however, they achieved similar survivorship as patients who met criteria for outpatient surgery. |
| format | Article |
| id | doaj-art-41b6b15aa89f411d8fc18b80c781fe17 |
| institution | Kabale University |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-41b6b15aa89f411d8fc18b80c781fe172025-02-12T05:31:18ZengElsevierArthroplasty Today2352-34412025-04-0132101631Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes?Justin Leal, BS0Christine J. Wu, MD1Niall H. Cochrane, MD2Thorsten M. Seyler, MD, PhD3William A. Jiranek, MD4Samuel S. Wellman, MD5Michael P. Bolognesi, MD6Sean P. Ryan, MD7Corresponding author. Department of Orthopaedic Surgery, Duke University, 5601 Arringdon Park Dr. Suite 300, Morrisville, NC 27560, USA. Tel.: +1 305 409 2237.; Department of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USADepartment of Orthopaedic Surgery, Duke University, Durham, NC, USABackground: This study compared outcomes between patients undergoing outpatient total joint arthroplasty (TJA) at an ambulatory surgery center (ASC) versus a cohort of medically and socially complex patients undergoing TJA at a tertiary healthcare system. Methods: An institutional database at a single academic center was retrospectively reviewed for patients who underwent primary TJA since the opening of an ASC from August 2021 to January 2024. A total of 716 (outpatient: 374; inpatient: 342) total knee arthroplasties and 458 (outpatient: 196; inpatient: 262) total hip arthroplasties met inclusion criteria. Results: Patients in the inpatient total knee arthroplasty group had a higher proportion of patients requiring an emergency department visit (11.4% vs 4.5%; P = .008) and admission (6.7% vs 2.7%; P = .025) within the first 90 days after surgery than the outpatient group; however, 2-year revision-free (97.9% vs 97.9%; P = .75) survival was similar between groups. Patients in the inpatient total hip arthroplasty group had a higher proportion of patients requiring an emergency department visit (13.0% vs 4.6%; P = .035) and admission (7.3% vs 1.0%; P = .018) within the first 90 days after surgery compared to the outpatient group; however, there was no difference in 2-year revision-free survival (96.4% vs 99.5%; P = .059). Conclusions: Medically and socially complex patients undergoing TJA required additional resources during the 90-day postoperative window; however, they achieved similar survivorship as patients who met criteria for outpatient surgery.http://www.sciencedirect.com/science/article/pii/S2352344125000184Outpatient arthroplastyInpatient arthroplastyAmbulatory surgery centerBundled paymentsPatient-reported outcome measures |
| spellingShingle | Justin Leal, BS Christine J. Wu, MD Niall H. Cochrane, MD Thorsten M. Seyler, MD, PhD William A. Jiranek, MD Samuel S. Wellman, MD Michael P. Bolognesi, MD Sean P. Ryan, MD Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes? Arthroplasty Today Outpatient arthroplasty Inpatient arthroplasty Ambulatory surgery center Bundled payments Patient-reported outcome measures |
| title | Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes? |
| title_full | Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes? |
| title_fullStr | Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes? |
| title_full_unstemmed | Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes? |
| title_short | Outpatient Versus Inpatient Total Joint Arthroplasty: Do Medically and Socially Complex Patients Require More Resources but Achieve Similar Outcomes? |
| title_sort | outpatient versus inpatient total joint arthroplasty do medically and socially complex patients require more resources but achieve similar outcomes |
| topic | Outpatient arthroplasty Inpatient arthroplasty Ambulatory surgery center Bundled payments Patient-reported outcome measures |
| url | http://www.sciencedirect.com/science/article/pii/S2352344125000184 |
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