Outpatient Total Hip Arthroplasty Performed at an Ambulatory Surgery Center versus Hospital Outpatient Setting: Complications, Revisions, and Readmissions

Background

Outpatient total hip arthroplasty (THA) utilization continues to grow. Literature suggest outpatient THA may result in low rates of complications and readmission. There are no studies comparing safety profiles of THA performed at ambulatory surgery centers (ASC) versus hospital outpatient (HOP) settings.

Methods

Prospectively collected data was reviewed on all patients who underwent THA from 2013 to 2018. ASC and HOP subgroups were compared, investigating difference in demographics, comorbidities, ASA subgroups, all complications, revisions, ER visits, and readmissions within the first 90 days of surgery. An additional subgroup analysis of patients aged under 65 years was performed.

Results

Two surgeons performed 3,063 THAs during the study period, including 965 outpatient cases (ASC = 335; HOP = 630). Thirty-seven (3.8%) complications occurred within 90 days. No differences were found between groups for 90-day complication rates (ASC = 13, 3.9%; HOP = 24, 3.8%) (p = 0.48), revision rates (ASC = 0, 0%; HOP = 2, 0.3%) (p = 0.30), all-cause reoperation rates (ASC = 1, 0.3%; HOP = 5, 0.8%) (p = 0.35), ED visits (ASC = 3, 0.9%; HOP = 2, 0.3%) (p = 0.23), or readmission rates (ASC = 2, 0.6%; HOP = 9, 1.4%) (p = 0.25).

Conclusion

THA can be safely performed in both ASC and HOP settings with low 90-day postoperative complication, revision, reoperation, ED visit, and readmission rates. Based on the populations studied, we identified no statistically significant differences in rates of complications between ASC and HOP groups.