Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

AIMS: The limited documentation on patients' perspectives on undergoing discharge on the day of surgery impedes its adoption as a standard of care. Hence, the aim of this study was to investigate whether patients were willing to repeat being discharged on the day of surgery if having a future hip or knee arthroplasty procedure.

METHODS: This multicentre, prospective consecutive cohort study spanned from 1 September 2022 to 31 January 2024, and was conducted at six public arthroplasty centres adhering to the same published protocol for discharge on the day of surgery following hip and knee arthroplasty. Patients undergoing primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (mUKA) were screened for eligibility and discharged when fulfilling predetermined discharge criteria. Patients discharged on the same calendar day of surgery were sent a questionnaire 30 days postoperatively.

RESULTS: Of 9,542 primary hip and knee arthroplasties registered, 3,457 (36%) were eligible for discharge on day of surgery; 58% of eligible patients (n = 2,011) were discharged on day of surgery and therefore received the survey. Baseline characteristics were comparable across all arthroplasty groups. The survey response rate was 88% (n = 1,771). Overall, 90% (95% CI 88 to 91) were willing to repeat discharge on the day of surgery if having a future joint arthroplasty, with 91% (95% CI 88 to 93) after THA, 89% (95% CI 86 to 92) after TKA, and 90% (95% CI 86 to 92) after mUKA. The difference between centres ranged from 84% to 93%. Patients responding 'no' to repeat discharge on the day of surgery were more often female (55%, n = 95) compared to patients responding 'yes' (47%, n = 744); otherwise, the groups were comparable.

CONCLUSION: A total of 90% of patients (n = 1,590) discharged on the day of surgery following hip and knee arthroplasty expressed willingness to repeat discharge on the day of surgery. This supports further implementation efforts.