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Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns.

Publication ,  Journal Article
Hernandez, NM; Ryan, SP; Wu, CJ; Hinton, ZW; Wellman, SS; Bolognesi, MP; Seyler, TM
Published in: J Orthop Surg (Hong Kong)
2020

PURPOSE: Bilateral total knee arthroplasty (TKA) can be performed in patients with bilateral knee arthritis. Outside of nationwide database studies, which have limitations, few studies have compared outcomes for same-day versus staged TKA. We sought to compare patient outcomes at a single tertiary referral center. METHODS: The institutional database was queried from March 2014 to December 2017 for primary TKA. Patients undergoing bilateral procedures were stratified by same-day versus staged; length of stay (LOS), disposition, 90-day emergency department (ED) visits, and 90-day readmissions were examined through univariable and multivariable analyses. RESULTS: A total of 676 patients were evaluated (113 same-day and 563 staged bilateral TKA patients) with mean age 66.0 (8.5) at first surgery and 292.1 (241.6) days between staged procedures. Same-day bilateral TKA patients were younger (p < 0.001), had lower body mass index (BMI) (p = 0.010), and had lower American Society of Anesthesiologists (ASA) scores (p = 0.030). They were more likely to have a prolonged LOS (p < 0.001) and be discharged to skilled nursing facility or rehab facility (p < 0.001). Total LOS for separate hospitalizations in staged procedures was greater than LOS for same-day bilateral TKAs (p < 0.001). There was no difference in 90-day ED visits (p = 0.623) or readmission (p = 0.286). In a multivariable model controlling for age, BMI, and ASA score, same-day bilateral TKA was not significantly associated with ED visits or readmissions. CONCLUSIONS: Patients undergoing same-day bilateral TKAs were more likely to be discharged to post-acute care facilities, however they did not have increased 90-day readmissions.

Duke Scholars

Published In

J Orthop Surg (Hong Kong)

DOI

EISSN

2309-4990

Publication Date

2020

Volume

28

Issue

2

Start / End Page

2309499020918170

Location

England

Related Subject Headings

  • Retrospective Studies
  • Osteoarthritis, Knee
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Hospitalization
  • Female
  • Arthroplasty, Replacement, Knee
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Hernandez, N. M., Ryan, S. P., Wu, C. J., Hinton, Z. W., Wellman, S. S., Bolognesi, M. P., & Seyler, T. M. (2020). Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns. J Orthop Surg (Hong Kong), 28(2), 2309499020918170. https://doi.org/10.1177/2309499020918170
Hernandez, Nicholas M., Sean P. Ryan, Christine J. Wu, Zoe W. Hinton, Samuel S. Wellman, Michael P. Bolognesi, and Thorsten M. Seyler. “Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns.J Orthop Surg (Hong Kong) 28, no. 2 (2020): 2309499020918170. https://doi.org/10.1177/2309499020918170.
Hernandez NM, Ryan SP, Wu CJ, Hinton ZW, Wellman SS, Bolognesi MP, et al. Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns. J Orthop Surg (Hong Kong). 2020;28(2):2309499020918170.
Hernandez, Nicholas M., et al. “Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns.J Orthop Surg (Hong Kong), vol. 28, no. 2, 2020, p. 2309499020918170. Pubmed, doi:10.1177/2309499020918170.
Hernandez NM, Ryan SP, Wu CJ, Hinton ZW, Wellman SS, Bolognesi MP, Seyler TM. Same-day Bilateral Total Knee Arthroplasty Did Not Increase 90-day Hospital Returns. J Orthop Surg (Hong Kong). 2020;28(2):2309499020918170.

Published In

J Orthop Surg (Hong Kong)

DOI

EISSN

2309-4990

Publication Date

2020

Volume

28

Issue

2

Start / End Page

2309499020918170

Location

England

Related Subject Headings

  • Retrospective Studies
  • Osteoarthritis, Knee
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Hospitals
  • Hospitalization
  • Female
  • Arthroplasty, Replacement, Knee