LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM

Fishley W, Paice S, Iqbal H, et al. LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM. Orthop Procs. 2023;105-B(SUPP_13):20-20. doi:10.1302/1358-992X.2023.13.020

Fishley, William, et al. “LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM.” Orthopaedic Proceedings, vol. 105-B, no. SUPP_13, 2023, pp. 20-20., https://doi.org/10.1302/1358-992X.2023.13.020

Fishley, W., Paice, S., Iqbal, H., Mowat, S., Kalson, N., Reed, M., Partington, P., & Petheram, T. (2023). LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM. Orthopaedic Proceedings, 105-B(SUPP_13), 20-20. https://doi.org/10.1302/1358-992X.2023.13.020

Fishley, W., Paice, S., Iqbal, H., Mowat, S., Kalson, N., Reed, M. et al. (2023) “LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM.” Orthopaedic Proceedings, 105-B(SUPP_13), pp. 20-20. Available at: https://doi.org/10.1302/1358-992X.2023.13.020

Fishley, William, Sarah Paice, Haaris Iqbal, Stephen Mowat, Nicholas Kalson, Mike Reed, Paul Partington, and Timothy Petheram. “LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM.” Orthopaedic Proceedings 105-B, no. SUPP_13 (2023): 20-20. https://doi.org/10.1302/1358-992X.2023.13.020

Fishley W, Paice S, Iqbal H, Mowat S, Kalson N, Reed M, et al. LOW READMISSION AND REATTENDANCE RATE FOR 301 CONSECUTIVE DAY-CASE TOTAL KNEE ARTHROPLASTIES DELIVERED IN A NATIONAL HEALTH SERVICE TRUST IN THE UNITED KINGDOM. Orthop Procs. 2023 Aug 7;105-B(SUPP_13):20-20. https://doi.org/10.1302/1358-992X.2023.13.020

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Abstract

Introduction

The rate of day-case total knee replacement (TKR) in the UK is currently ~0.5%. Reducing length of stay improves efficiency, increases operative throughput and tackles the rising demand for joint replacement surgery and the COVID-19 related backlog. We report safe delivery of day-case TKR in an NHS Trust via inpatient wards, with no additional resources.

Methodology

Day-case TKRs, defined as patients discharged on the same calendar day as surgery, were retrospectively reviewed with a minimum follow-up of six-months. Analysis of hospital and primary care records was performed to determine readmission and reattendance rates. Telephone interviews were conducted to determine patient satisfaction.

Results

Between 2016 and 2021, 301/7350 (4.1%) TKRs were discharged on the day of surgery. Mean follow-up was 31.4 (6.2–70.0) months. 28 (9.3%) patients attended Accident and Emergency or other acute care settings within 90-days of surgery; six (2.0%) patients were readmitted. No patients underwent a subsequent revision procedure. There were no prosthetic infections. Two patients underwent secondary patella resurfacing, and one patient underwent arthroscopic arthrolysis after previous manipulation under anaesthetic (MUA). Three patients underwent MUA alone. Primary care consultation records, available for 206 patients, showed 16 (7.8%) patients contacted their General Practitioner within two-weeks post-operatively; two (1.0%) were referred to secondary care. 115/121 (95%) patients telephoned stated they would have day-case TKR again.

Conclusion

Day-case TKR can be safely delivered in the NHS with no additional resources. We found low incidence of contact with primary and secondary care in the post-operative period, and high patient satisfaction.