Yoeri Bemelmans

Chapter 8 124 Abstract Purpose General consensus of patient selection criteria for outpatient joint arthroplasty is lacking, which is paramount to prevent prolonged hospital stay, adverse events and/ or readmissions. This review highlights patient selection criteria for OJA based on the current literature and expert opinion. Methods A search of the English and International electronic healthcare databases includingMEDLINE/PubMed, EMBASE, AMEDand the Cochrane librarywas performed in November 2015 to include studies published during the last 10 years. Furthermore, a survey of physicians from different specialties was performed. Results Fourteenstudiesdescribedresults regardingoutpatient joint arthroplasty. Studies on outpatient hip and/or knee arthroplasty resulted in similar outcome in preselected patients. Patients who are able and willing to participate, with a low ASA classification (<III), undergoing primary arthroplasty, age <75 and with support at home during the first postoperative days are eligible candidates for outpatient joint arthroplasty. Patients with a high ASA classification (>II), bleeding disorders, poorly controlled and/or severe cardiac (e.g. heart failure, arrhythmia) or pulmonary (e.g. embolism, respiratory failure) comorbidities, uncontrolled DM (type I or II), a high BMI (>30 m2/kg), chronic opioid consumption, functional neurological impairments, dependent functional status, chronic/endstage renal disease and/or reduced preoperative cognitive capacity should be excluded from outpatient joint arthroplasty. The expert opinion-based selection criteria were comparable to literature with a further extension of exclusion for patients with practical issue’s, urologic medical history and/or severe mobility disorders. Conclusion Based on the current literature, the presented patient selection criteria provide a basis for outpatient joint arthroplasty and can be useful when selecting patients. Together with a change inmindset, amultidisciplinary approach and literature- based protocols, outpatient joint arthroplasty can be applied in daily orthopaedic practice while ensuring patients’ safety. Keywords Outpatient surgery; Hip arthroplasty; Knee arthroplasty; Patient selection criteria