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Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust
AIMS: The rate of day-case total knee arthroplasty (TKA) in the UK is currently approximately 0.5%. Reducing length of stay allows orthopaedic providers to improve efficiency, increase operative throughput, and tackle the rising demand for joint arthroplasty surgery and the COVID-19-related backlog....
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The British Editorial Society of Bone & Joint Surgery
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442176/ https://www.ncbi.nlm.nih.gov/pubmed/37604493 http://dx.doi.org/10.1302/2633-1462.48.BJO-2023-0043.R1 |
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author | Fishley, William G. Paice, Sarah Iqbal, Haaris Mowat, Stephen Kalson, Nicholas S. Reed, Mike Partington, Paul Petheram, Timothy G. |
author_facet | Fishley, William G. Paice, Sarah Iqbal, Haaris Mowat, Stephen Kalson, Nicholas S. Reed, Mike Partington, Paul Petheram, Timothy G. |
author_sort | Fishley, William G. |
collection | PubMed |
description | AIMS: The rate of day-case total knee arthroplasty (TKA) in the UK is currently approximately 0.5%. Reducing length of stay allows orthopaedic providers to improve efficiency, increase operative throughput, and tackle the rising demand for joint arthroplasty surgery and the COVID-19-related backlog. Here, we report safe delivery of day-case TKA in an NHS trust via inpatient wards with no additional resources. METHODS: Day-case TKAs, defined as patients discharged on the same calendar day as surgery, were retrospectively reviewed with a minimum follow-up of six months. Analysis of hospital and primary care records was performed to determine readmission and reattendance rates. Telephone interviews were conducted to determine patient satisfaction. RESULTS: Since 2016, 301/7350 TKAs (4.1%) in 290 patients at our institution were discharged on the day of surgery. Mean follow-up was 31.4 months (6.2 to 70.0). In all, 28 patients (9.3%) attended the emergency department or other acute care settings within 90 days of surgery, most often with wound concerns or leg swelling; six patients (2.0%) were readmitted. No patients underwent a subsequent revision procedure, and there were no periprosthetic infections. Two patients (0.7%) underwent secondary patella resurfacing, and one patient underwent arthroscopic arthrolysis after previous manipulation under anaesthetic (MUA). Three patients (1.0%) underwent MUA alone. Primary care consultation records, available for 206 patients, showed 16 patients (7.8%) contacted their general practitioner within two weeks postoperatively; two (1.0%) were referred to secondary care. Overall, 115/121 patients (95%) telephoned stated they would have day-case TKA again. CONCLUSION: Day-case TKA can be safely delivered in the NHS with no additional resources. We found low incidence of contact with primary and secondary care in the postoperative period, and high patient satisfaction. Cite this article: Bone Jt Open 2023;4(8):621–627. |
format | Online Article Text |
id | pubmed-10442176 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The British Editorial Society of Bone & Joint Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-104421762023-08-22 Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust Fishley, William G. Paice, Sarah Iqbal, Haaris Mowat, Stephen Kalson, Nicholas S. Reed, Mike Partington, Paul Petheram, Timothy G. Bone Jt Open Knee AIMS: The rate of day-case total knee arthroplasty (TKA) in the UK is currently approximately 0.5%. Reducing length of stay allows orthopaedic providers to improve efficiency, increase operative throughput, and tackle the rising demand for joint arthroplasty surgery and the COVID-19-related backlog. Here, we report safe delivery of day-case TKA in an NHS trust via inpatient wards with no additional resources. METHODS: Day-case TKAs, defined as patients discharged on the same calendar day as surgery, were retrospectively reviewed with a minimum follow-up of six months. Analysis of hospital and primary care records was performed to determine readmission and reattendance rates. Telephone interviews were conducted to determine patient satisfaction. RESULTS: Since 2016, 301/7350 TKAs (4.1%) in 290 patients at our institution were discharged on the day of surgery. Mean follow-up was 31.4 months (6.2 to 70.0). In all, 28 patients (9.3%) attended the emergency department or other acute care settings within 90 days of surgery, most often with wound concerns or leg swelling; six patients (2.0%) were readmitted. No patients underwent a subsequent revision procedure, and there were no periprosthetic infections. Two patients (0.7%) underwent secondary patella resurfacing, and one patient underwent arthroscopic arthrolysis after previous manipulation under anaesthetic (MUA). Three patients (1.0%) underwent MUA alone. Primary care consultation records, available for 206 patients, showed 16 patients (7.8%) contacted their general practitioner within two weeks postoperatively; two (1.0%) were referred to secondary care. Overall, 115/121 patients (95%) telephoned stated they would have day-case TKA again. CONCLUSION: Day-case TKA can be safely delivered in the NHS with no additional resources. We found low incidence of contact with primary and secondary care in the postoperative period, and high patient satisfaction. Cite this article: Bone Jt Open 2023;4(8):621–627. The British Editorial Society of Bone & Joint Surgery 2023-08-22 /pmc/articles/PMC10442176/ /pubmed/37604493 http://dx.doi.org/10.1302/2633-1462.48.BJO-2023-0043.R1 Text en © 2023 Author(s) et al. https://creativecommons.org/licenses/by-nc-nd/4.0/https://online.boneandjoint.org.uk/TDMThis is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/ |
spellingShingle | Knee Fishley, William G. Paice, Sarah Iqbal, Haaris Mowat, Stephen Kalson, Nicholas S. Reed, Mike Partington, Paul Petheram, Timothy G. Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust |
title | Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust |
title_full | Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust |
title_fullStr | Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust |
title_full_unstemmed | Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust |
title_short | Low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case TKAs delivered in a UK NHS trust |
title_sort | low readmission and reattendance rate in day-case total knee arthroplasties: a retrospective case series of 301 consecutive day-case tkas delivered in a uk nhs trust |
topic | Knee |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10442176/ https://www.ncbi.nlm.nih.gov/pubmed/37604493 http://dx.doi.org/10.1302/2633-1462.48.BJO-2023-0043.R1 |
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