Patient Selection in Outpatient and Short-Stay Total Knee Arthroplasty


The purpose of the current study is to identify patients who are at high risk for rehospitalization, revision, complications, and mortality after outpatient and short-stay total knee arthroplasty (TKA). The Medicare 5% limited data set sample was used to identify patients with a TKA procedure who were treated in an outpatient setting or who were discharged within 1 or 2 days in the hospital setting. Rehospitalization risk increased with higher Charlson score (i.e., poorer health status), older patients, inpatients (vs. outpatients), patients not receiving a femoral nerve block, earlier (vs. recent) year of surgery, and those with a recent history of heart failure. The findings of this study suggest that existing comorbidities, particularly heart failure, have the greatest effect on event risk after outpatient and short-stay TKA. The information obtained from this study should assist with patient selection for TKA performed on an outpatient basis. (Journal of Surgical Orthopaedic Advances 23(1):2–8, 2014)

Scott Lovald, PhD; Kevin Ong, PhD; Edmund Lau, MS; Girish Joshi, MD; Steven Kurtz, PhD; and Arthur Malkani, MD