10 年日间髋膝关节置换术演变：2010 年至 2020 年丹麦全国登记研究的 166833 例手术

10-year evolution of day-case hip and knee arthroplasty: a Danish nationwide register study of 166,833 procedures from 2010 to 2020.

机构信息

Department of Orthopaedic Surgery, Clinical Orthopaedic Surgery Hvidovre (CORH), Copenhagen University Hospital Hvidovre, Hvidovre.

Department of Anaesthesiology, Copenhagen University Hospital Hvidovre, Hvidovre.

出版信息

Acta Orthop. 2023 Apr 18;94:178-184. doi: 10.2340/17453674.2023.11961.

BACKGROUND AND PURPOSE

No previous studies have investigated the use of day-case arthroplasty in Denmark on a national scale. We investigated the frequency of day-case surgery in total hip (THA), total knee (TKA), and unicompartmental knee arthroplasty (UKA) from 2010 to 2020 in Denmark.

PATIENTS AND METHODS

Primary unilateral THAs, TKAs, and UKAs performed for osteoarthritis were identified in the Danish National Patient Register using procedural and diagnosis codes. Day-case surgery was defined as discharge on the day of surgery. 90-day readmissions were defined as any overnight admissions following discharge.

RESULTS

From 2010 to 2020 Danish surgical centers performed 86,070 THAs, 70,323 TKAs, and 10,440 UKAs. From 2010 to 2014, less than 0.5% of THAs and TKAs were day-case procedures. They increased to 5.4% (95% confidence interval [CI] 4.9-5.8) of THAs and 2.8% (CI 2.4-3.2) of TKAs in 2019. From 2010 to 2014, 11% of UKAs were day-case procedures, but they increased to 20% (CI 18-22) in 2019. This increase was driven by a few surgical centers (3-7 centers). In 2010, readmission rates within 90 days of surgery were 10% after THAs and 11% after TKAs, and 9.4% for both THAs and TKAs in 2019. Readmission rates after UKA fluctuated between 4% and 7%.

CONCLUSION

From 2010 to 2020 the use of day-case surgery in THA, TKA, and UKA increased in Denmark, driven by only a few centers. During the same period readmissions did not increase.

背景与目的

以前没有研究在丹麦全国范围内调查日间手术在全髋关节置换术（THA）、全膝关节置换术（TKA）和单髁膝关节置换术（UKA）中的应用。我们调查了 2010 年至 2020 年丹麦的原发性单侧 THA、TKA 和 UKA 的手术频率，这些手术是由骨关节炎引起的。使用手术和诊断代码在丹麦国家患者登记处确定了日间手术病例。日间手术定义为手术当天出院。90 天再入院定义为出院后任何过夜住院。

患者和方法

从 2010 年至 2020 年，丹麦外科中心共进行了 86070 例 THA、70323 例 TKA 和 10440 例 UKA。从 2010 年至 2014 年，不到 0.5%的 THA 和 TKA 是日间手术。到 2019 年，THA 增加到 5.4%（95%置信区间[CI]4.9-5.8），TKA 增加到 2.8%（CI 2.4-3.2）。从 2010 年至 2014 年，11%的 UKA 是日间手术，但到 2019 年增加到 20%（CI 18-22）。这一增长是由少数几家外科中心（3-7 家）推动的。2010 年，THA 术后 90 天内的再入院率为 10%，TKA 术后为 11%，2019 年 THA 和 TKA 均为 9.4%。UKA 术后再入院率在 4%至 7%之间波动。