Yoeri Bemelmans

Chapter 8 126 consensus on the included studies concerning patient selection criteria for OJA was achieved between the authors. Quality assessment was performed on the included studies using the Critical Appraisal Skills Programme (CASP) tools [8]. The study flow chart is demonstrated in Fig. 1. Besides this extended literature search, a survey of seven physicians from different specialties in the hospital (cardiology, pulmonology, internal medicine, geriatricmedicine, urology, neurology and psychiatry) was performed. All the experts were familiar with the OJA pathway. In daily practice, in cases of pre-existing comorbidities, patients were screened and treated by these experts. Theywere asked to give their expert opinion on possible inclusion and exclusion criteria, based on general comorbidities and comorbidities which were related to their disciplines. Figure 1 . Flow chart of database search with excluded and included studies for final analysis. Database search (MEDLINE/PUBMED, EMBASE, AMED and the Cochrane library) n=619 Excluded studies after screening title and abstract; n=600 Eligible studies for inclusion n=19 Excluded articles N=5 (not available full-text article n=3, review article n=2) Included studies n=14 Outpatient joint arthroplasty (OJA) pathway at the ZuyderlandMedical Center Indications for hip and knee arthroplasty were osteoarthritis, pain and loss of function as generally accepted [32, 33, 35]. Patients could be included in the OJA pathway if they satisfied three criteria; (1) able and willing to participate in the OJA pathway, (2) able to understand the procedures and (3) a personal coach (partner or relative) needs to be involved as much as possible, to inspire, correct, and support the patient during the first 48hpostoperatively. Patientswith severe cardiologic, pulmonary and/or internal diseases (e.g. diabetes mellitus (DM), renal function disorders) that required additional pre-, peri- and postoperative treatment were excluded. Patients who were not able to understand