Effect of Early Discharge on Postoperative Comorbidity and Complications for Patients Undergoing Revision Total Knee Arthroplasty

Background: Total knee arthroplasty (TKA) is becoming an increasingly common procedure to alleviate knee pain often associated with osteoarthritis (OA) of the knee. As the number of TKAs performed continue to increase, there remains a debate regarding efficacy of discharging patients earlier than the conventional 3-4 days in the postoperative period. A variety of studies have begun to shown that early discharge has an economical benefit, while causing either a reduction or no difference in patient outcomes. This study aims to determine effect of early discharge on postoperative complications in those that undergo revision TKA. Methods: A retrospective cohort study was conducted using data collected through the American College of Surgeons National Quality Improvement Program Database. All patients who underwent revision TKA between 2007 and 2014 were identified and stratified into groups based on discharge date. The incidence of adverse events following surgery was evaluated with univariate and multivariate analyses where appropriate. Results: Patients that were discharged earlier were found to be less likely to develop a deep wound infection, urinary tract infection, sepsis or require a reoperation in the OR within 30 days. Furthermore, earlier discharge was found to be an independent risk factor for these complications. Conclusions: Patients that are discharged earlier have a decreased risk for a variety of complications in the postoperative period, while reducing economic burden. If patients are appropriate candidates, surgeons should consider early discharge as a viable option even in the revision TKA population