This recent study, published in the Journal of Arthoplasty by Gondusky et al1 reported that discharge on the same day as PKA allows for "efficient care of the appropriately selected patient" and a high level of patient satisfaction.
160 consecutive patients, with an average age of 65, were successfully discharged on the DOS (Day of Surgery) between January 2003 and February 2013. The majority (73.1%) of patients received an Oxford Partial Knee implant.
Important steps in the DOS discharge protocol include (but are not limited to):
- Preoperative and postoperative patient education through counselling
- A very simple perioperative pathway
- Detailed instructions in a patient handbook
- Strict patient selection criteria: patients must meet specific health criteria and are not only capable of complying with specific DOS discharge protocols, but also with PKA in general
This study shows that, when patients are carefully selected, DOS discharge after PKA allows for "efficient care of the appropriately selected patient" by using a very simple perioperative pathway. The following results were reported:
- A low rate of perioperative complications (5 out of 160 patients)
- High patient satisfaction: 92.8% were very or extremely satisfied at final follow up; average 2 years
Another study also found that significant cost savings can be achieved with DOS discharge ($7,000) versus a 3-4 day hospital stay (average cost of $16,000)2.