Yoeri Bemelmans

General introduction 13 1 The following chapters focusses on three major issues in primary hip and knee arthroplasty; firstly, the introduction of TXA (chapter 3), to reduce blood loss and prevent for allogenic blood transfusions after hip and knee surgery, was examined. Secondly, LIA in total knee arthroplasty (TKA), administered via an intra-operative single shot analgesic mixture with or without adrenaline was studied (chapter 4). And finally, examination of amanagement protocol for prevention of urinary retention after hip and knee arthroplasty was performed (chapter 5). Part two continues the journey on implementing an OJA pathway. Chapter 6 presents the first results of a selective group of patients undergoing unicompartmental knee arthroplasty (UKA) in an outpatient setting. These patients were compared to a match cohort of patients receiving the standard of care (inpatient). A systematic reviewwith meta-analysis was performed to review the current literature regarding OJA pathways compared to the standard of care (chapter 7). Chapter 8 shows an evidence based statement regarding patient selection criteria for OJA pathways. To prevent for (S)AEs in the (early) postoperative phase and to successfully discharge patients on the day of surgery, adequate patient selection is paramount. In chapter 9 patients’ physical activity after TKA was assessed in the patients’ home-environment. Patients’ activity level undergoing TKAon an outpatient basewere compared to patients undergoing surgery in an inpatient (fast-track) pathway. Finally, a comparison between outpatient and inpatient arthroplasty patients in the improvement of quality of life after surgery is outlined in chapter 10.