Outpatient total hip or knee arthroplasty in ambulatory surgery center versus arthroplasty ward: a randomized controlled trial

Figures & data

Figure 1. Flow chart of included THA patients.

Figure 2. Flow chart of included TKA patients.

Table 1. Inclusion criteria

•Patients with clinical and radiological osteoarthritis of the hip suitable for primary cementless THA and patients with clinical and radiological osteoarthritis of the knee suitable for primary CR TKA

•Age 18–80

•ASA < 3

•Interested in and motivated for discharge on DOS

•Family/relatives to be present for > 24 hours after discharge

•Able to understand and give consent to the study

Table 2. Discharge criteria

•Activity level: Steady gait with crutches, no dizziness. Stairs if required

•Nausea and/or vomiting: Minimal and efficiently treated with or without medications

•Vital signs: Must be stable and consistent with age and preoperative baseline. Systolic blood pressure within 20 mmHg of preoperative levels. Saturation > 95%. Pulse < 100 while resting

•Pain: The level of pain that the patient has should be acceptable to the patient. VAS < 3 at rest and VAS < 5 on mobilization

•Surgical bleeding: Postsurgical bleeding should be consistent with expected blood loss for the procedure and not require repeated dressing change. Patients should be hemodynamically stable (no tachycardia (pulse >100 at rest) and hypotension sBP < 100) and show no clinical signs of anemia (paleness, dizziness during mobilization and fatigue).

Table 3. Demographics, numbers, and statistical significance

	Ambulatory	Arthroplasty
TKA patients	surgery center	ward	p-value
Male, n (%)	8	5
Female, n (%)	8	9
BMI, mean (SD)	28 (4.2)	29 (4.5)
Age (years), mean (SD)	58 (7.7)	63 (10.1)
ASA score 1, n (%)	8	4
ASA score 2, n (%)	8	10
Surgery time (min), mean (SD)	56 (11)	53 (9)	0.5
Blood loss (mL), mean (SD)	209 (78)	179 (77)	0.3
OKS, mean (SD)
pre-surgery)	26 (6)	22 (7)	0.05
3 months post-surgery	35 (5)	29 (9)	0.03
ΔOKS	9 (9)	7 (9)	0.7
	Ambulatory	Arthroplasty
THA patients	surgery center	ward	p-value
Male, n (%)	4	5
Female, n (%)	5	6
BMI, mean (SD)	25 (5)	26 (5)
Age (years), mean SD	58 (8.8)	60 (7.2)
ASA score 1, n (%)	6	9
ASA score 2, n (%)	3	2
Surgery time (min), mean (SD)	61 (12)	54 (8)	0.1
Blood loss (mL), mean (SD)	272 (218)	272 (154)	1.0
OHS, mean (SD)
pre-surgery	24 (4)	21 (3)	0.1
3 months post-surgery	41 (3)	38 (7)	0.3
ΔOHS	17 (5)	17 (6)	0.9