A prospective study of day of surgery discharge in 368 consecutive patients with unicompartmental knee replacement

Abstract

Introduction: There has been an increased focus on fast-track (FT) programmes and the potential to convert unicompartmental knee replacement (UKR) from short-term admission to outpatient surgery. However, relatively few studies have been presented and with differences in selection criteria and completion rates. The purpose of this study was to describe patient selection and completion rates in a patient group undergoing UKR in two high-volume FT knee surgery clinics.

Methods: All consecutive patients (n = 368) referred to and selected for UKR were screened for eligibility for outpatient surgery with discharge on the day of surgery (DOS). Reasons why the patients were not discharged were recorded in patients not completing the outpatient pathway, and readmissions and complications were recorded until three months post-operatively.

Results: Among all referred and screened patients, 69% were considered eligible for outpatient surgery. DOS discharge occurred in 59% of the operated patients and in 37% of all referred and screened patients. Main reasons for why patients were not discharged were active wound drainage and lack of mobilisation due to pain, nausea and vomiting. Two patients were readmitted during the first 24 hours due to wound drainage. One patient had a lung embolus and one patient an acute myocardial infarction during the follow-up period.

Conclusions: This study illustrates that not all patients in a consecutive patient group for UKR were feasible for outpatient surgery. Further studies should focus on optimising pain treatment and reducing post-operative nausea.

Funding: none.

Trial registration: not relevant.