Experience with an Outpatient Total Knee Arthroplasty Program in Chile: Evaluating Safety and Feasibility

Abstract

Introduction

Total knee arthroplasty (TKA) has evolved into a successful and safe procedure for treating severe osteoarthritis of the knee with a projected increase in incidence. Outpatient TKA has emerged as an efficient alternative, supported by technological advancements, rehabilitation protocols, and anesthetic techniques.

Objective

To describe the safety and short-term costs of outpatient and inpatient TKA at a hospital and analyze associated complications and reinterventions.

Materials and Methods

An observational retrospective study was conducted on patients who underwent primary TKA in 2022 at a single hospital. Patients with unicompartmental or revision arthroplasty were excluded. Patients were classified into two groups: outpatient (group 1) and inpatient (group 2). Demographic data was collected, and safety (emergency consultations in the first postoperative week), postoperative complications, reinterventions, mortality, and associated costs were evaluated.

Results

A total of 347 primary TKA procedures were registered, of which 267 (77%) were outpatient and 80 (23%) were inpatient, with a mean follow-up of 21 months (17–28). Nine early consultations (3.3%) were reported in the outpatient group and five (6.2%) in the inpatient group during the first 7 postoperative days. There were 18 reoperations in the outpatient group (6.7%) and nine (11.2%) in the inpatient group. No deaths were reported. Individual savings were USD 1,034, with total savings of USD 276,130.

Conclusion

Outpatient total knee arthroplasty is a safe procedure with complication rates similar to those in the inpatient setting and offers significant cost savings for both patients and the healthcare system.

Keywords

outpatient - total knee arthroplasty - postoperative complications - cost analysis

Publication History

Received: 20 December 2024

Accepted: 02 April 2025

Article published online:
20 May 2025

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