Is Outpatient Unicompartmental Knee Arthroplasty Safe to Perform at an Ambulatory Surgery Center? A Comparative Study of Early Post-Operative Complications.

Abstract

Unicompartmental knee arthroplasty (UKA) lends itself to the outpatient surgical setting. Prior literature has established a low rate of readmission and post-operative complications when performed in a hospital outpatient setting (HOP). To our knowledge, there have been no studies comparing complications of UKA performed at an ambulatory surgery center (ASC) and those in a HOP. We retrospectively reviewed all patients who underwent outpatient UKA by a single surgeon from 2012 to 2016. In all 569 outpatient UKAs were performed: 288 in the ASC group and 281 in the HOP group. We compared the groups with regard to all complications within the first 90 days after surgery. Thirty minor and major complications occurred within 90 days (5.3%). There was no difference in the overall complication rate between groups (ASC 12, 4.2%; HOP 18, 6.4%) (P = .26). Day of surgery admission occurred once in the HOP group (0.4%) and did not occur in the ASC group (P = .49). There was 1 visit to the emergency department (ED) <24 hours from surgery in each group (ASC 0.3%, HOP 0.4%) (P = 1.0). ED visits occurred within 7 days in 3 ASC cases (1.0%) and 4 HOP cases (1.4%) (P = .72). Re-admissions in the first 90 days occurred in 5 ASC cases (1.7%) and 8 HOP cases (2.8%) (P = .41). UKA at an ASC has a low early postoperative complication rate without increased risk of re-admission or ED evaluation when compared to UKAs performed at a HOP.