Experiencia en Programa de Artroplastia Total de Rodilla Ambulatoria de un Centro en Chile: ¿Una Opción Segura y Viable?

Resumen

Introducción

La artroplastia total de rodilla (ATR) ha evolucionado como un procedimiento exitoso y seguro para tratar la gonartrosis severa, con una incidencia proyectada a aumentar significativamente. La ATR ambulatoria ha surgida como una alternativa eficiente, respaldada por avances tecnológicos, protocolos de rehabilitación y técnicas anestésicas.

Objetivo

Describir la seguridad y los costos a corto plazo de las ATR ambulatorias y hospitalizadas en un centro hospitalario y analizar las complicaciones asociadas y reintervenciones.

Materiales y Métodos

Se realizó un estudio retrospectivo, observacional, en pacientes sometidos a ATR primaria durante 2022 en un mismo centro hospitalario. Se excluyeron pacientes operados mediante artroplastia unicompartimental o de revisión. Los pacientes fueron clasificados en dos grupos: ambulatorio (Grupo 1) y hospitalizado (Grupo 2). Se recopilaron datos demográficos y se evaluaron la seguridad del procedimiento (consultas en urgencias durante la primera semana postoperatoria), las complicaciones postoperatorias, las reintervenciones, la mortalidad y los costos asociados.

Resultados

Se registraron 347 ATR primarias, de las cuales 267 (77%) fueron ambulatorias y 80 (23%) hospitalizadas, con un seguimiento promedio de 21 meses (17–28). Se reportaron 10 consultas precoces (3,7%) en el grupo ambulatorio y 5 (6,2%) en el hospitalario durante los primeros 7 días postoperatorios. Hubo 18 reintervenciones en el grupo ambulatorio (6,7%) y 9 (11,2%) en el hospitalario. No se registraron fallecimientos. El ahorro individual fue de 1.034 dólares, acumulando un total de 276.130 dólares.

Conclusión

La artroplastia total de rodilla ambulatoria es un procedimiento seguro, con tasas de complicaciones similares a las del entorno hospitalario, y ofrece un ahorro económico considerable tanto para los pacientes como para el sistema de salud.

Palabras Clave

ambulatorio - artroplastia total de rodilla - complicaciones postoperatorias - análisis de costos

Publication History

Received: 20 December 2024

Accepted: 02 April 2025

Article published online:
20 May 2025

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