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- Title
Patient selection criteria for outpatient joint arthroplasty.
- Authors
Kort, Nanne; Bemelmans, Yoeri; Kuy, P.; Jansen, Jacqueline; Schotanus, Martijn; Kort, Nanne P; Bemelmans, Yoeri F L; van der Kuy, P Hugo M; Schotanus, Martijn G M
- Abstract
<bold>Purpose: </bold>General consensus of patient selection criteria for outpatient joint arthroplasty is lacking, which is paramount to prevent prolonged hospital stay, adverse events and/or readmissions. This review highlights patient selection criteria for OJA based on the current literature and expert opinion.<bold>Methods: </bold>A search of the English and International electronic healthcare databases including MEDLINE/PubMed, EMBASE, AMED and the Cochrane library was performed in November 2015 to include studies published during the last 10 years. Furthermore, a survey of physicians from different specialties was performed.<bold>Results: </bold>Fourteen studies described results regarding outpatient joint arthroplasty. Studies on outpatient hip and/or knee arthroplasty resulted in similar outcome in preselected patients. Patients who are able and willing to participate, with a low ASA classification (<III), undergoing primary arthroplasty, age <75 and with support at home during the first postoperative days are eligible candidates for outpatient joint arthroplasty. Patients with a high ASA classification (>II), bleeding disorders, poorly controlled and/or severe cardiac (e.g. heart failure, arrhythmia) or pulmonary (e.g. embolism, respiratory failure) comorbidities, uncontrolled DM (type I or II), a high BMI (>30 m2/kg), chronic opioid consumption, functional neurological impairments, dependent functional status, chronic/end-stage renal disease and/or reduced preoperative cognitive capacity should be excluded from outpatient joint arthroplasty. The expert opinion-based selection criteria were comparable to literature with a further extension of exclusion for patients with practical issue's, urologic medical history and/or severe mobility disorders.<bold>Conclusion: </bold>Based on the current literature, the presented patient selection criteria provide a basis for outpatient joint arthroplasty and can be useful when selecting patients. Together with a change in mindset, a multidisciplinary approach and literature-based protocols, outpatient joint arthroplasty can be applied in daily orthopaedic practice while ensuring patients' safety.<bold>Level Of Evidence: </bold>Clinical review, Level III.
- Subjects
ARTHROPLASTY; PATIENT selection; TOTAL hip replacement; AMBULATORY surgery; KNEE surgery; ARTIFICIAL joints; HEALTH outcome assessment
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2017, Vol 25, Issue 9, p2668
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-016-4140-z