Research generally finds comparable outcomes for outpatient, inpatient orthopaedic surgeries

As the effectiveness of anaesthesia, pain management and rehabilitation continues to improve, more orthopaedic procedures are being done on an outpatient basis. In a new research study same-day total joint replacement (TJR) patient outcomes were comparable to those of patients admitted to the hospital and staying at least one night following surgery. However, readmission rates, although statistically 'non-significant,' were higher for outpatient procedures. In a related study, a very low complication rate (.23 percent) was found in a review of more than 28,737 hand and upper extremity surgeries at an outpatient speciality clinic.

'Our study supports the view that outpatient surgery can offer patients and physicians options for safe, cost-effective surgical care, offering improved patient comfort, increased efficiency and low complication rates.'

Many surgeons are now performing TJR as a same day procedure, with patients discharged within 24 hours of surgery. Outpatient TJR has 'the potential benefit to cut costs and improve patient satisfaction,' however, concerns for patient recovery, as well as increased Medicare scrutiny and financial penalties for unplanned hospital re-admissions within 30 days of surgery, is deterring some doctors and hospitals from routinely performing outpatient surgeries, said David N. Vegari, MD, a Philadelphia orthopaedic surgeon and lead author of the study, 'Implications of Outpatient vs. Inpatient Total Joint Arthroplasty on Hospital Readmission Rates.'

In the study, researchers reviewed outcomes for 235 patients who underwent either outpatient (137 patients) or inpatient (98 patients) total knee or total hip replacement surgery between September 2010 and May 2011. Patients receiving outpatient surgery had a body mass index (BMI) =40 kg/m