Comparing patient outcomes following outpatient total joint arthroplasty in a hospital setting versus an ambulatory surgery center

Background: Traditionally, total joint arthroplasty has been performed as an inpatient procedure, sometimes requiring a hospital stay of a few days. However, outpatient total joints have gained popularity in recent years. The purpose of this study is to compare patient outcomes following an outpatient total knee arthroplasty (TKA) or a total hip arthroplasty (THA) in a hospital setting versus an ambulatory surgical center. Method: This study was a prospective study of patients receiving either a TKA or THA, with results up to one year. All cases were performed by one board certified orthopedic surgeon. Each of the patients routinely completed patient reported outcome measures at the preoperative and postoperative visits for up to one year postoperatively. Results: At three-month follow-up, there were no observed differences in the PROMIS, KOOS Jr, HOOS Jr, Oxford Hip, Oxford Knee, or mHHS scores between the cohorts. At one-year follow-up, there were no statistical differences in any PROMs between the ASC and hospital cohorts. In addition, subgroup analysis was performed comparing PROMs between patient's based on specific subgroups: diabetics, BMI >30, BMI<30, gender, and age, which showed non-statitistical differences at one year. Conclusion: We believe that this study confirms that same day discharge, outpatient total joint procedures can be performed safely and effectively from either the hospital or ASC setting. While there were some differences in perceived outcomes at 3-months for some subgroups, these were not statistically significant at the 1-year after follow-up.