Zhao Guanghui, Ma Chengyuan, Ma Jianbing, Wang Jianpeng
Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, No.555 East Youyi Road, Xi'an, 710054, Shaanxi, China.
Arthroplasty. 2025 Jun 9;7(1):28. doi: 10.1186/s42836-025-00316-z.
While same-day discharge models for knee arthroplasty have gained significant traction in China's evolving healthcare landscape, patient perspectives on ambulatory surgical pathways remain underexplored. This qualitative study addresses a critical gap in the literature by systematically assessing patient experiences and perceptions regarding knee arthroplasty within China's emerging ambulatory care framework.
A prospective cohort of 195 consecutive patients scheduled for primary knee arthroplasty at a tertiary orthopedic referral center underwent structured data collection through the WenJuanXing platform between January 1 and June 1, 2024. This cross-sectional survey employed an anonymous voluntary survey instrument administered at two critical timepoints: 1) prior to any clinical discussions regarding postoperative care pathways, and 2) before initiation of standardized preoperative education protocols.
In total, 188 participants (96%, 188/195) completed the survey. Of them, 70% were female and 84% were 60 years or older. While 68% were familiar with ambulatory surgery, awareness did not significantly differ by age (P = 0.64), sex (P = 0.19), occupation (P = 0.42), location (P = 0.55), or education level (P = 0.81). Interestingly, only 8 patients anticipated discharge within 24 h post-surgery, with most (71.8%) expecting a 3-day or more stay. However, if postoperative care was assured, 66% expressed comfort with same-day or 24-h discharge. 93% considered ambulatory knee arthroplasty suitable, and 71.8% believed it would yield superior outcomes through quicker recovery and reduced complications, infections, and pain. Despite this optimism, only 45% were willing to endure longer waits, and a third were open to paying more or traveling farther for ambulatory knee arthroplasty.
The study reveals that most Chinese patients initially want ≥ 3-day stays but may accept 24-h discharge for knee arthroplasty. One-third are unaware of ambulatory knee arthroplasty, so more education is needed as procedures rise.
虽然膝关节置换术的当日出院模式在中国不断发展的医疗环境中已获得显著关注，但患者对门诊手术路径的看法仍未得到充分探索。这项定性研究通过系统评估中国新兴门诊护理框架内患者对膝关节置换术的体验和认知，填补了文献中的一个关键空白。
2024年1月1日至6月1日期间，在一家三级骨科转诊中心，对195例连续计划接受初次膝关节置换术的患者组成的前瞻性队列，通过问卷星平台进行结构化数据收集。这项横断面调查采用匿名自愿调查问卷，在两个关键时间点进行：1）在任何关于术后护理路径的临床讨论之前；2）在开始标准化术前教育方案之前。
共有188名参与者（96%，188/195）完成了调查。其中，70%为女性，84%年龄在60岁及以上。虽然68%的人熟悉门诊手术，但知晓率在年龄（P = 0.64）、性别（P = 0.19）、职业（P = 0.42）、地点（P = 0.55）或教育水平（P = 0.81）方面无显著差异。有趣的是，只有8名患者预计术后24小时内出院，大多数（71.8%）预计住院3天或更长时间。然而，如果术后护理得到保证，66%的人对当日或24小时出院表示安心。93%的人认为门诊膝关节置换术合适，71.8%的人认为通过更快康复、减少并发症、感染和疼痛，该手术会产生更好的效果。尽管如此乐观，但只有45%的人愿意忍受更长的等待时间，三分之一的人愿意为门诊膝关节置换术支付更多费用或前往更远的地方就医。
研究表明，大多数中国患者最初希望住院≥3天，但对于膝关节置换术可能接受24小时出院。三分之一的人不了解门诊膝关节置换术，因此随着手术的增加，需要更多的教育。
