Exploration And Practice of Ambulatory Surgery Mode for Total Knee Replacement

Wu Yanjie; Zhang Yanning; Ma Jianbing; Zhang Yuming

Abstract：Objective To analyze the effect of ambulatory surgery pathways in total knee arthroplasty(TKA).Methods A retrospective analysis was performed on the clinical data of 1,014 patients who underwent TKA at Xi'an Honghui Hospital from August 2023 to January 2024.A 1∶1 matching method was used to select 507 cases in the ambulatory surgery group and 507 cases in the conventional surgery group.The day surgery group included 183 males and 324 females,aged 50 to 84 years,with an average age of(66.99±6.17)years.The conventional surgery group included 169 males and 338 females,aged 51 to 87 years,with an average age of(67.28±6.45)years.The two groups were compared in terms of visual analogue scale(VAS)for pain,Charlson comorbidity index(CCI),hospitalization costs,length of hospital stay,joint range of motion,the incidence of postoperative deep vein thrombosis(DVT),and 30-day readmission rate.Results The postoperative follow-up period was 1 year,with an average follow-up of(12.40±2.40)months.The two groups had no significant difference in VAS scores or 30-day readmission rates(P＞0.05).The day surgery group showed lower hospitalization costs,preoperative hospital stay,postoperative hospital stay,total hospital stay,incidence of postoperative DVT,and better postoperative joint range of motion than the conventional surgery group(P＜0.001).Preoperative CCI was positively correlated with the incidence of postoperative thrombosis.Conclusion Compared with the conventional surgery model,the ambulatory surgery model for TKA demonstrates better postoperative outcomes,lower hospitalization costs,and shorter hospital stays,which is worthy of clinical promotion.