Same Day Total Hip Arthroplasty Performed at an Ambulatory Surgical Center: 90 Day Complication Rate on 549 Patients

Abstract Background There is an increasing interest in outpatient THA as there are perceived benefits to the patient, insurer and overall healthcare system. However, the safety of outpatient TJA has not been studied Methods 549 patients who underwent mini-posterior THA at a freestanding independent ambulatory surgical center were reviewed. All patients were discharged home the day of surgery. Results The average age of the patients was 54.4 years (range 27-73). The average ASA score was 1.6 (range 1-3). 3/549 (0.5%) patients were admitted from the surgery center to our local hospital. One patient was admitted for pain control after failing to disclose his long term high dose narcotic dependence, one patient was admitted for an acetabular component migration identified on postop xray, and one patient was admitted for hypotension, bradycardia and an acute polyarthralgia exacerbation. An additional patient was seen two days after surgery in a local emergency department for oversedation secondary to narcotics and later discharged home. Conclusion Outpatient THA at an ambulatory surgical center is safe and effective when performed on the appropriately indicated patient. There were four visits to the hospital on the day of surgery. Only one was related to medical events, two were pain control/medication related and the final was technique related. Known orthopedic complications including infection, dislocation and DVT appear consistent with the literature for a series of this size. Same day discharge THA in an ambulatory surgical center is safe and reproducible.