Outpatient total hip and knee arthroplasty - Patient expectations versus experience

Justin D Bric; Emilie N Miley; Hari K Parvataneni; Luis Pulido; Hernan A Prieto; Chancellor F Gray; Justin T Deen

doi:10.1016/j.jor.2024.01.014

Outpatient total hip and knee arthroplasty - Patient expectations versus experience

J Orthop. 2024 Feb 1:51:109-115. doi: 10.1016/j.jor.2024.01.014. eCollection 2024 May.

Authors

Justin D Bric¹, Emilie N Miley², Hari K Parvataneni³, Luis Pulido³, Hernan A Prieto², Chancellor F Gray³, Justin T Deen³

Affiliations

¹ The Southeast Permanente Medical Group, Atlanta, GA, USA.
² Department of Orthopaedic Surgery, College of Medicine, University of Florida, Gainesville, FL, USA.
³ Florida Orthopedic Institute, Gainesville, FL, USA.

PMID: 38371352
PMCID: PMC10867624 (available on 2025-05-01)
DOI: 10.1016/j.jor.2024.01.014

Abstract

Aims & objectives: With modern advancements in surgical techniques and rapid recovery protocols, incidence of outpatient total joint arthroplasty (TJA) is increasing. Previous literature has historically focused on cost, safety, and clinical outcomes, with few studies investigating patient expectations and experiences. The aim of this study was to survey preoperative patient expectations related to outpatient TJA surgery compared with perioperative perceptions and experience.

Materials & methods: Prospective study of patients undergoing outpatient total hip or knee arthroplasty at a single Tertiary Academic center. Preoperative and postoperative surveys were administered during routine clinic visits.

Results: One hundred and six patients completed preoperative surveys; 79 completed postoperative surveys and were included in the final data analysis. Fifty (63.3 %) patients reported being aware of outpatient TJA prior to undergoing the procedure. There was no difference between preoperative anticipated pain control and postoperative perceived pain control (6.64 vs. 6.88, p = 0.77). Most postoperative patients (N = 56, 70.9 %) rated outpatient surgery as "much better" or "better" than expected. Most postoperative patients (N = 68, 86 %) would opt to have outpatient surgery again. Fifty-two (65.8 %) of postoperative patients believed outpatient surgery sped up their postoperative rehabilitation.

Conclusion: For most patients, the outpatient surgical experience met or exceeded expectations. Nearly 90 % of patients would prefer to have outpatient surgery in the future, further supporting the continued migration of elective arthroplasty away from inpatient sites of care.

Keywords: Outpatient hip replacement; Outpatient knee replacement; Outpatient total hip arthroplasty; Outpatient total knee arthroplasty; Patient experience.