Open AccessSuccessful same‐day discharge in 88% of patients after unicompartmental knee arthroplasty: a systematic review and meta‐analysis
Author(s) -
Bayoumi Tarik,
List Jelle P.,
Ruderman Lindsey V.,
Zuiderbaan Hendrik A.,
Kerkhoffs Gino M. M. J.,
Pearle Andrew D.
Publication year - 2023
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-022-07094-0
Subject(s) - unicompartmental knee arthroplasty , medicine , meta analysis , confidence interval , cochrane library , subgroup analysis , complication , systematic review , medline , adverse effect , arthroplasty , surgery , osteoarthritis , alternative medicine , pathology , political science , law
Abstract Purpose The purpose of this study was to evaluate the effectiveness of day‐case unicompartmental knee arthroplasty (UKA) by assessment of successful same‐day discharge (SDD), readmission, complication and reoperation rates in the recent literature. Methods For this systematic review and meta‐analysis, PubMed, Embase and Cochrane Library were comprehensively searched to identify all eligible studies reporting outcomes of day‐case UKA. Studies with intended same‐day home discharge after UKA were included. A meta‐analysis of proportions, using a random‐effects model, was performed to estimate overall rates of successful SDD and adverse events. Subgroup analyses were performed for studies including selected patients (i.e., patients had to meet certain patient‐specific criteria to be eligible for day‐case UKA) and unselected patients (i.e., no additional criteria for day‐case UKA), as well as for clinical and registry‐based studies. Additional outcomes included reasons for the failure of SDD and patient satisfaction. Results A total of 29 studies and 9694 patients were included with a mean age of 66 ± 9 years and mean follow‐up of 59 days (mean range 30–270 days). Based on 24 studies (2733 patients), the overall successful SDD rate was 88% (95% confidence interval [CI] 80–92). These rates were 91% (95% CI 84–95) across studies with selected patients and 76% (95% CI 55–89) across studies with unselected patients. Overall readmission, complication and reoperation rates were 3% (95% CI 1.9–4.4), 4% (95% CI 2.8–5.2) and 1% (95% CI 0.8–1.3), respectively. Inability to mobilize, nausea and uncontrolled pain were frequently reported reasons for failed SDD. The overall patient satisfaction rate was 94%. Conclusion This systematic review with meta‐analysis found an overall successful SDD rate of 88% after UKA in a heterogeneous cohort of selected and unselected patients. Readmission, complication and reoperation rates suggest UKA can be performed safely and effectively as a same‐day discharge procedure. Level of evidence Level IV, systematic review of level III and IV studies.