Day-case hip and knee arthroplasty does not increase healthcare system contacts: a prospective multicenter study in a public healthcare setting.

BACKGROUND AND PURPOSE

Discharge on day of surgery after hip or knee arthroplasty is increasing, but whether this leads to an increase in the overall number of post-discharge healthcare system contacts is unknown. We aimed to investigate whether day-case surgery leads to increased patient-reported healthcare system contacts compared with non-day-case surgery within the first 30 days postoperatively.

METHODS

We performed a prospective multicenter study at seven fast-track centers from September 2022 to August 2023. Candidates for primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or unicompartmental knee arthroplasty (UKA) were evaluated for day-case eligibility using pre-defined criteria. Patients received a survey 30 days postoperatively regarding any healthcare system contacts related to surgery. Planned healthcare visits were excluded. We used day-case eligible patients not discharged on day of surgery (inpatients) as control group.

RESULTS

Of 2,278 day-case eligible patients, 2,073 (91%) completed the survey, including 1,146 day-case patients (55%) and 927 inpatients (45%). The overall rate of healthcare system contacts was 49% (95% confidence interval [CI] 45-51) in day-case patients compared with 52% (CI 49-56) in inpatients. Specific contacts included visits to a general practitioner (GP) or out-of-hours medical clinic (25% [CI 22-27] vs 32% [CI 29-35]), the emergency department (ED) (6% [CI 4-7] vs 7% [CI 5-8]), and outpatient clinics or wards (35% [CI 33-38] vs 35% [CI 32-38]). The most common reasons for all types of healthcare contacts were wound problems, prescription renewals, and pain management.

CONCLUSION

Day-case hip and knee arthroplasties was not associated with increased healthcare system contacts within the first 30 days postoperatively.