Yoeri Bemelmans

Patient selection criteria for outpatient hip and knee arthroplasty 133 8 Readmission (rate) Prolonged hospital stay FU CASP score NA** NA* 1 year 8 1.6% (not further specified) NA* 2 years 9 Expert opinion All medical specialists agreed and participated. Table 2 presents an overview of expert opinion-based patient selection criteria per given discipline. Discussion The most important finding of the present study was that an extensive and well- conducted patient selection procedure is needed to perform safe and effective OJA with acceptable clinical outcome. Despite OJA being increasingly applied in daily orthopaedic practice, general consensus on patient selection criteria is lacking. It is known that comorbidities can predispose patients to increased AEs, readmission rates and increased length of hospital stay [7, 28, 30]. Patient selection seems to be crucial in the prevention of AEs and readmissions [4, 15]. This selection for OJA patients was previously studied by Lovald et al. [28, 30]. In the latest series [28], outpatient and short- stay TKA patients were analysed as one cohort. These results are of major interest in patient selection; however, the selection criteria for outpatient TKAwere not described. In addition, the question remains whether outpatient TKA resulted in comparable outcome as the short-stay group, since enhanced recovery pathways are increasingly applied as the standard care for arthroplasty [22]. In previous series [30], standardized 3–4 night’s hospitalizationwere comparedwith outpatient, shortened or extended stay. Unfortunately, the inclusion and exclusion criteria for outpatient TKAwere not reported. On the other hand, the results showed that outpatient TKA improved more in terms of functioning, quality of life and short-term outcomes including lower incidence of knee pain and stiffness. Despite there were no significant differences found between groups, awareness for potential increase of postoperative complications in outpatient and short- stay TKA was suggested. When implementing an outpatient surgery pathway for hip and/or knee arthroplasty, surgeons need to consider proper patient selection criteria to prevent AEs and readmissions while ensuring the quality of care, to maintain patient