Clinical Report: Outpatient Unicompartmental Knee Arthroplasty and Same-Day Surgery Outcomes
Overview
Outpatient unicompartmental knee arthroplasty (UKA) with same-day discharge is feasible and safe in carefully selected patients, showing comparable levels of anxiety, depression, pain, and satisfaction to standard fast-track UKA. This approach may further reduce hospital stay without increasing perioperative complications or psychological distress.
Background
Unicompartmental knee arthroplasty traditionally required prolonged hospitalization, but fast-track pathways have reduced length of stay to about one day with good outcomes. Outpatient UKA with same-day discharge has emerged as a logical progression, demonstrating promising safety and low complication rates. However, the psychological impact of outpatient UKA, particularly regarding anxiety and depression, had not been previously studied. Given that psychological symptoms can adversely affect surgical outcomes, evaluating mental well-being in outpatient UKA patients is critical.
Data Highlights
Parameter
Outpatient UKA (n=20)
Fast-track UKA (n=20)
Discharge on Day of Surgery
85-100%
Not applicable (overnight stay)
Adverse Events, Complications, Readmissions
Low incidence, comparable to fast-track
Low incidence
Patient Age
<70 years
<70 years
ASA Classification
1-2
1-2
BMI
<35 kg/m2 (exclusion)
<35 kg/m2 (exclusion)
Key Findings
Outpatient UKA patients were carefully selected based on age, ASA status, BMI, and absence of significant comorbidities or mental illness.
Same-day discharge was achieved in nearly all outpatient UKA cases without increased adverse events compared to fast-track UKA.
Outpatient UKA patients received a personalized educational meeting with a nurse practitioner and had a personal coach available post-discharge.
An opioid-sparing multimodal pain management protocol was used in outpatient UKA, differing from the fast-track opioid-inclusive regimen.
Levels of perioperative anxiety, depression, pain, and patient satisfaction in outpatient UKA were comparable to those in fast-track UKA patients.
Clinical Implications
Outpatient UKA with same-day discharge can be safely implemented in selected patients, potentially improving resource utilization and patient throughput. Careful patient selection, comprehensive preoperative education, and tailored pain management protocols are essential to maintain psychological well-being and clinical outcomes. Monitoring and support during the immediate postoperative period remain critical to ensure safety and satisfaction.
Conclusion
Outpatient unicompartmental knee arthroplasty with same-day discharge is a viable and safe alternative to fast-track protocols, without compromising psychological health or clinical outcomes in appropriately selected patients. This approach represents a promising advancement in knee arthroplasty care pathways.
References
Author/Source/Year -- Exploring Outpatient Unicompartmental Knee Arthroplasty: Addressing Concerns About Same-Day Surgery
