J Knee Surg 2019; 32(08): 730-735
DOI: 10.1055/s-0039-1683935
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Inpatient versus Outpatient Total Knee Arthroplasty

Paul K. Edwards
1  Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Jeffrey L. Milles
1  Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Jeffrey B. Stambough
1  Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
C. Lowry Barnes
1  Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
,
Simon C. Mears
1  Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas
› Author Affiliations
Further Information

Publication History

10 December 2018

05 February 2019

Publication Date:
28 March 2019 (online)

Abstract

The rise of improved perioperative recovery protocols after total knee arthroplasty (TKA) has led to faster, more streamlined hospital stays for many patients. Combined with the implementation of value-based care and bundled payment initiatives, there has been a paradigm shift toward outpatient TKA surgery. This change to practice has been accelerated by recent policy changes enacted by the Center for Medicaid and Medicare Services regarding the removal of TKA as an inpatient only procedure as well as some insurance companies denying preauthorization for inpatient stays after TKA. Our review aims to address the inclusion and exclusion criteria for outpatient TKA consideration, examine the outcomes for outpatient joint replacement surgery, and discuss limitations of widespread adoption for same-day discharges.