Cozzarelli Nicholas F, Longenecker Andrew S, Uhr Alex, Davis Daniel E, Lonner Jess H
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, USA.
Cureus. 2023 Feb 16;15(2):e35059. doi: 10.7759/cureus.35059. eCollection 2023 Feb.
Increasingly, unicompartmental knee arthroplasty (UKA) is being performed on an outpatient basis, with the growing utilization of ambulatory surgery centers (ASCs). The purpose of this study was to compare the costs of UKAs performed in an ASC to UKAs done in a hospital, either on an outpatient or inpatient basis.
This study involved three matched groups, each with 50 consecutive patients, undergoing UKA either on an outpatient basis in an ASC or a community hospital, or who were admitted overnight to the same community hospital. Identical perioperative analgesic regimens and care protocols were used in each group. The primary outcomes evaluated included direct facility costs. Secondary outcomes were postoperative complications and readmissions.
Average age, gender ratio, and comorbidities were similar in all three cohorts. Only two patients in the study experienced complications and these were without secondary adverse consequences. Mean costs were substantially reduced when UKAs were performed in an ASC ($9,025) compared to a community hospital on either an outpatient ($12,032) or inpatient basis ($14,542).
UKA can be safely performed in the outpatient setting, in appropriately selected patients, at substantial cost savings, particularly when performed in an ASC.
随着门诊手术中心（ASC）的日益普及，单髁膝关节置换术（UKA）越来越多地在门诊进行。本研究的目的是比较在ASC进行的UKA与在医院进行的门诊或住院UKA的成本。
本研究涉及三个匹配组，每组连续50例患者，分别在ASC或社区医院门诊接受UKA，或在同一社区医院住院过夜。每组采用相同的围手术期镇痛方案和护理协议。评估的主要结果包括直接设施成本。次要结果是术后并发症和再入院情况。
三个队列的平均年龄、性别比例和合并症相似。研究中只有两名患者出现并发症，且无继发不良后果。与社区医院门诊（12,032美元）或住院（14,542美元）相比，在ASC进行UKA时，平均成本大幅降低（9,025美元）。
在适当选择的患者中，UKA可以在门诊安全进行，且成本大幅节省，尤其是在ASC进行时。
