Outpatient Total Knee Arthroplasty: A Meta-Analysis
<b>Introduction:</b> Outpatient total knee arthroplasty (TKA) is attracting growing interest. This meta-analysis compared patient reported outcome measures (PROMs), infection, readmission, revision, deep vein thrombosis (DVT), and mortality rates of outpatient versus inpatient TKA. <b...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Applied Sciences |
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| Online Access: | https://www.mdpi.com/2076-3417/11/20/9376 |
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| author | Filippo Migliorini Andrea Pintore Lucio Cipollaro Francesco Oliva Nicola Maffulli |
| author_facet | Filippo Migliorini Andrea Pintore Lucio Cipollaro Francesco Oliva Nicola Maffulli |
| author_sort | Filippo Migliorini |
| collection | DOAJ |
| description | <b>Introduction:</b> Outpatient total knee arthroplasty (TKA) is attracting growing interest. This meta-analysis compared patient reported outcome measures (PROMs), infection, readmission, revision, deep vein thrombosis (DVT), and mortality rates of outpatient versus inpatient TKA. <b>Methods:</b> This meta-analysis was conducted according to the 2020 PRISMA statement. In August 2021, the following databases were accessed: Pubmed, Web of Science, Google Scholar, Embase. All the clinical trials comparing outpatient versus inpatient (>2 days) TKA were considered. Studies which reported data on revision settings were not considered, nor studies which included patients discharged between one and two days. <b>Results:</b> Data from 159,219 TKAs were retrieved. The mean follow-up was 5.8 ± 7.6 months. The mean age was 63.7 ± 5.0 years and the mean BMI 30.3 ± 1.8 kg/m<sup>2</sup>. Comparability was found in age (<i>p</i> = 0.4), BMI (<i>p</i> = 0.3), and gender (<i>p</i> = 0.4). The outpatient group evidenced a greater Oxford knee score (<i>p</i> = 0.01). The inpatient group demonstrated a greater rate of revision (<i>p</i> = 0.03), mortality (<i>p</i> = 0.003), and DVT (<i>p</i> = 0.005). No difference was found in the rate of readmission (<i>p</i> = 0.3) and infection (<i>p</i> = 0.4). <b>Conclusions:</b> With regards to the endpoints evaluated in this meta-analysis, current evidence does not support outpatient TKA. However, given the limited data available for inclusion and the overall poor quality of the included articles, no reliable conclusion can be inferred. Further high quality clinical trials with clear eligibility criteria are required. |
| first_indexed | 2024-03-10T06:45:13Z |
| format | Article |
| id | doaj.art-465e5ea5fd814e3e8b62951028aad7f5 |
| institution | Directory Open Access Journal |
| issn | 2076-3417 |
| language | English |
| last_indexed | 2024-03-10T06:45:13Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Applied Sciences |
| spelling | doaj.art-465e5ea5fd814e3e8b62951028aad7f52023-11-22T17:17:32ZengMDPI AGApplied Sciences2076-34172021-10-011120937610.3390/app11209376Outpatient Total Knee Arthroplasty: A Meta-AnalysisFilippo Migliorini0Andrea Pintore1Lucio Cipollaro2Francesco Oliva3Nicola Maffulli4Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, GermanyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, SA, Italy<b>Introduction:</b> Outpatient total knee arthroplasty (TKA) is attracting growing interest. This meta-analysis compared patient reported outcome measures (PROMs), infection, readmission, revision, deep vein thrombosis (DVT), and mortality rates of outpatient versus inpatient TKA. <b>Methods:</b> This meta-analysis was conducted according to the 2020 PRISMA statement. In August 2021, the following databases were accessed: Pubmed, Web of Science, Google Scholar, Embase. All the clinical trials comparing outpatient versus inpatient (>2 days) TKA were considered. Studies which reported data on revision settings were not considered, nor studies which included patients discharged between one and two days. <b>Results:</b> Data from 159,219 TKAs were retrieved. The mean follow-up was 5.8 ± 7.6 months. The mean age was 63.7 ± 5.0 years and the mean BMI 30.3 ± 1.8 kg/m<sup>2</sup>. Comparability was found in age (<i>p</i> = 0.4), BMI (<i>p</i> = 0.3), and gender (<i>p</i> = 0.4). The outpatient group evidenced a greater Oxford knee score (<i>p</i> = 0.01). The inpatient group demonstrated a greater rate of revision (<i>p</i> = 0.03), mortality (<i>p</i> = 0.003), and DVT (<i>p</i> = 0.005). No difference was found in the rate of readmission (<i>p</i> = 0.3) and infection (<i>p</i> = 0.4). <b>Conclusions:</b> With regards to the endpoints evaluated in this meta-analysis, current evidence does not support outpatient TKA. However, given the limited data available for inclusion and the overall poor quality of the included articles, no reliable conclusion can be inferred. Further high quality clinical trials with clear eligibility criteria are required.https://www.mdpi.com/2076-3417/11/20/9376total knee arthroplastyinpatientoutpatient |
| spellingShingle | Filippo Migliorini Andrea Pintore Lucio Cipollaro Francesco Oliva Nicola Maffulli Outpatient Total Knee Arthroplasty: A Meta-Analysis Applied Sciences total knee arthroplasty inpatient outpatient |
| title | Outpatient Total Knee Arthroplasty: A Meta-Analysis |
| title_full | Outpatient Total Knee Arthroplasty: A Meta-Analysis |
| title_fullStr | Outpatient Total Knee Arthroplasty: A Meta-Analysis |
| title_full_unstemmed | Outpatient Total Knee Arthroplasty: A Meta-Analysis |
| title_short | Outpatient Total Knee Arthroplasty: A Meta-Analysis |
| title_sort | outpatient total knee arthroplasty a meta analysis |
| topic | total knee arthroplasty inpatient outpatient |
| url | https://www.mdpi.com/2076-3417/11/20/9376 |
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