Meneghini R Michael, Ziemba-Davis Mary
Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana; Indiana University Health Physicians Orthopedics and Sports Medicine, IU Health Saxony Hospital, Fishers, Indiana.
Indiana University Health Physicians Orthopedics and Sports Medicine, IU Health Saxony Hospital, Fishers, Indiana.
J Arthroplasty. 2017 Sep;32(9):2701-2705.e1. doi: 10.1016/j.arth.2017.04.006. Epub 2017 Apr 13.
There has been increasing interest in outpatient total joint arthroplasty (TJA) in the orthopedic community, but how patients feel about outpatient TJA is unknown. The purpose of this study was to understand patient perspectives on hip and knee replacements performed in an outpatient setting.
We surveyed 110 consecutive patients scheduled for primary TJA in an academic suburban arthroplasty practice regarding their knowledge and perceptions of outpatient TJA. Questionnaires were administered during preoperative clinic visits before discussion of surgery location, length of stay, and before preoperative joint replacement education.
Fifty-seven percent of respondents were female, and 42.7% were aged 65 years or older. Very few patients expected same-day discharge (n = 3) or a one night stay in the hospital (n = 17). Fifty-four percent of patients were expected to stay in the hospital two or more nights. Only 54.5% of patients were aware that outpatient TJA is an option, with 55.3% of men and 31.7% of women reporting that they were comfortable with outpatient TJA (P = .030). In contrast, 61% and 72.8% believed that faster recovery and decreased likelihood of infection are likely advantages of outpatient TJA. Interestingly, 51.9% felt ambulatory surgery centers are as safe as hospitals, and 62.6% believed that home is the best place to recovery from TJA.
These observations suggest that there is need for patient education regarding outpatient TJA. As outpatient procedures become more common, it is essential that patients understand the ambulatory surgery process, the benefits and risks of same day discharge, and their role in a successful outpatient experience.
骨科领域对门诊全关节置换术（TJA）的兴趣日益浓厚，但患者对门诊TJA的感受尚不清楚。本研究的目的是了解患者对在门诊进行髋膝关节置换术的看法。
我们对一家学术性郊区关节置换诊所连续安排进行初次TJA的110名患者进行了调查，了解他们对门诊TJA的了解和看法。在术前门诊就诊期间，在讨论手术地点、住院时间以及术前关节置换教育之前发放问卷。
57%的受访者为女性，42.7%的受访者年龄在65岁及以上。很少有患者期望当天出院（n = 3）或住院一晚（n = 17）。54%的患者预计住院两晚或更长时间。只有54.5%的患者知道门诊TJA是一种选择，55.3%的男性和31.7%的女性表示他们对门诊TJA感到放心（P = .030）。相比之下，61%和72.8%的人认为更快康复和感染可能性降低可能是门诊TJA的优势。有趣的是，51.9%的人认为门诊手术中心与医院一样安全，62.6%的人认为家是TJA术后康复的最佳场所。
这些观察结果表明，需要对患者进行门诊TJA相关教育。随着门诊手术越来越普遍，患者了解门诊手术过程、当天出院的益处和风险以及他们在成功的门诊体验中的作用至关重要。
