Outpatient Simultaneous Bilateral Total Knee Arthroplasty: Is it Safe?

Published:January 10, 2022DOI:https://doi.org/10.1016/j.arth.2022.01.012

      Abstract

      Introduction

      It is currently unknown if simultaneous bilateral total knee arthroplasty (si-BTKA) can also be safely performed in the outpatient setting. The primary aim of this study was to compare 30-day postoperative complication rates between outpatient and inpatient si-BTKA.

      Methods

      Adults undergoing simultaneous bilateral total knee arthroplasty (si-BTKA) from 2015-2019 were queried using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Our primary analysis compared the rates of complications between outpatient si-BTKA and inpatient si-BTKA using bivariate comparisons and multivariable logistic regression of outpatient and inpatient cases controlling for differences in baseline demographics and comorbidities.

      Results

      From 2015 to 2019, the utilization of outpatient si-BTKA increased from 0.6% to 10.5%. Outpatient si-BTKA were found to have significantly lower odds of any complication (OR=0.49), minor complication (OR=0.50), and postoperative transfusion (OR=0.66) compared to inpatient cases. Outpatient si-BTKA also had significantly shorter operative time.

      Conclusion

      Compared to inpatient si-BTKA, patients who undergo outpatient si-BTKA do not demonstrate increased rates of any complication, severe complications, and minor complications within 30-days postoperatively. Further insight is needed on the effect of outpatient si-BTKA on long-term outcomes.

      Key Words

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