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. 2025 Sep 26;6(9):1156-1163.
doi: 10.1302/2633-1462.69.BJO-2025-0109.R1.

Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

Oddrún Danielsen  1   2 , Kirill Gromov  1   3 , Claus Varnum  1   4 , Thomas H Jakobsen  1   5 , Mikkel R Andersen  1   6 , Manuel J Bieder  1   7 , Christoffer C Jørgensen  1   8 , Henrik Kehlet  1   9 , Martin Lindberg-Larsen  1   2
Affiliations

Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

Oddrún Danielsen et al. Bone Jt Open. .

Abstract

Aims: The limited documentation on patients' perspectives on undergoing discharge on the day of surgery impedes its adoption as a standard of care. Hence, the aim of this study was to investigate whether patients were willing to repeat being discharged on the day of surgery if having a future hip or knee arthroplasty procedure.

Methods: This multicentre, prospective consecutive cohort study spanned from 1 September 2022 to 31 January 2024, and was conducted at six public arthroplasty centres adhering to the same published protocol for discharge on the day of surgery following hip and knee arthroplasty. Patients undergoing primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (mUKA) were screened for eligibility and discharged when fulfilling predetermined discharge criteria. Patients discharged on the same calendar day of surgery were sent a questionnaire 30 days postoperatively.

Results: Of 9,542 primary hip and knee arthroplasties registered, 3,457 (36%) were eligible for discharge on day of surgery; 58% of eligible patients (n = 2,011) were discharged on day of surgery and therefore received the survey. Baseline characteristics were comparable across all arthroplasty groups. The survey response rate was 88% (n = 1,771). Overall, 90% (95% CI 88 to 91) were willing to repeat discharge on the day of surgery if having a future joint arthroplasty, with 91% (95% CI 88 to 93) after THA, 89% (95% CI 86 to 92) after TKA, and 90% (95% CI 86 to 92) after mUKA. The difference between centres ranged from 84% to 93%. Patients responding 'no' to repeat discharge on the day of surgery were more often female (55%, n = 95) compared to patients responding 'yes' (47%, n = 744); otherwise, the groups were comparable.

Conclusion: A total of 90% of patients (n = 1,590) discharged on the day of surgery following hip and knee arthroplasty expressed willingness to repeat discharge on the day of surgery. This supports further implementation efforts.

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Conflict of interest statement

M. R. Andersen is a board member of the Danish Society for Hip and Knee Surgery. All authors are members of the steering committee for the Centre for Fast-track Hip and Knee Arthroplasty and declared no conflicts of interest related to this study. O. Danielsen's PhD salary was provided through funding from the Candys Foundation, University of Southern Denmark and Region of Southern Denmark. K. Gromov reports institutional support and research support from Zimmer Biomet, unrelated to this study. C. C. Jørgensen reports speaker fees and support for attending meetings and/or travel from Pharmacosmos, unrelated to this study, and is Co-chair of the European guidelines on peri-operative venous thromboembolism prophylaxis. M. Lindberg-Larsen is Chairman of the steering committee of the Danish Knee Arthroplasty Register. C. Varnum reports institutional support from Stryker for attending meetings and/or travel, unrelated to this study.

Figures

Fig. 1
Fig. 1
Flowchart of patient inclusion in the study. THA, total hip arthroplasty; TKA, total knee arthroplasty; mUKA, medial unicompartmental knee arthroplasty
Fig. 2
Fig. 2
a) Proportion of patients willing to repeat being discharged on day of surgery compared with those unwilling. b) Proportion of patients willing to repeat being discharged on day of surgery, presented on a timeline.
Fig. 3
Fig. 3
Proportion of patients willing to repeat being discharged on day of surgery divided by surgical procedure. THA, total hip arthroplasty; TKA, total knee arthroplasty; UKA, unicompartmental knee arthroplasty.
Fig. 4
Fig. 4
Proportion of patients willing to repeat being discharged on the day of surgery divided by centre. Overall discharge on the day of surgery represents the proportion of eligible patients discharged on the day of surgery out of all patients. Eligible discharge on day of surgery represents the proportion of eligible patients discharged on day of surgery out of eligible patients. Proportion of 'yes' responders.
See this image and copyright information in PMC

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