Yoeri Bemelmans

Patient selection criteria for outpatient hip and knee arthroplasty 125 8 Introduction In recent years, care pathways in orthopaedic surgery have improved, resulting in high quality of patient care with increased patient satisfaction [19, 23]. Outpatient surgical pathways are designed for elective surgery patients, as these patients are admitted and discharged on the same day without an overnight stay in a hospital bed [9]. These pathways were first used for less complex surgeries, and there have been an increasing number of more complex surgeries performed on an outpatient basis. Due to the advancement of these multidisciplinary pathways, outpatient joint arthroplasty (OJA) is increasingly performed in the general practice of orthopaedic departments, which allows more arthroplasty procedures to be performed and may be cost effective while preserving the quality of care [17]. Previous studies have found that OJA is a safe and effective procedure without increased incidence of peri- and post-operative complications [2, 4–6, 10–13, 15, 16, 26, 27, 30]. These studies included preselected patients, whereas patients with severe comorbidities were excluded. Recently, Lovald et al. [28] concluded that pre-existing comorbidities and particularly heart failure are major risk factors for adverse events (AEs) after outpatient and short-stay total knee arthroplasty (TKA). The evidence for patient selection criteria for OJA is limited, and no generally applicable criteria exist to safely operate OJA patients. Nevertheless, it is paramount to develop these criteria, as they affect clinical outcomes and the incidence of postoperative complications [4]. This review highlights patient selection criteria for OJA based on current literature and expert opinion. Materials andmethods A search of the English and International electronic healthcare databases including MEDLINE/PubMed, EMBASE, AMED and the Cochrane library was performed in November 2015 to include studies published during the last 10 years (2005–2015). The following keywords were used: ‘outpatient’, ‘day care surgery’, ‘hip arthroplasty’ and ‘knee arthroplasty’ which were combined with AND/OR as follows: (outpatient surgery OR day care surgery) AND (hip arthroplasty OR knee arthroplasty). The lead author performed the search and the results were agreed on by a consensus of two other authors (YB, MS), who independently reviewed the list of titles and all studies concerning outpatient surgery and arthroplasty and, if available, the abstracts to determine their potential usefulness. All studies on outpatient knee and/or hip arthroplasty were eligible for inclusion, with exclusion of review articles. Only full-text published articles were used. A consensus method was used to resolve disagreements, and the third or fourth author (JJ, HK) was consulted. Prior to formulating general conclusions, final