The Canadian Medical Association Journal (CMAJ) has published a literature review of observational and interventional research on the effectiveness of same-day total hip and total knee arthroplasty. The review reports on key takeaways:
- Same-day discharge total hip and knee arthroplasty is becoming more common, made feasible by perioperative advances such as minimally invasive surgical approaches, the use of tranexamic acid and multimodal and pre-emptive analgesia.
- According to protocols developed to ensure patient safety, candidates for same-day surgery are people younger than 80 years without preoperative bleeding disorders, cirrhosis, clinically important cardiac disease or end-stage renal disease.
- When patients are selected appropriately, rates of adverse events and functional outcomes are similar to those observed among patients who undergo inpatient-protocol arthroplasty, patient satisfaction is high, and procedures are cost-effective.
- Careful education of patients, by surgeons and primary care physicians, can help to dispel myths about outpatient total joint arthroplasty and thereby optimize success.