Yoeri Bemelmans

Quality of life after outpatient and fast-track hip and knee arthroplasty 159 10 than PROMs alone. A potential criticism in the study was the significant differences in baseline condition. To ensure a proper comparison, both groups should be equal (e.g. age, gender and ASA classification). On the other hand, our primary goal was to compare two pathways inwhich different patient selection criteria were used. Practical applicability of simplified protocols and new techniques are progressive. Although, these optimisations are associated with initial costs, they will reduce costs for the long term [26]. Firstly theremust be an investment in training, knowledge and adjustments to daily practice for the surgeon, nurse and physiotherapist [27]. Good cooperation between these professionals and patients are necessary. All disciplines should be informed about, and involved in the whole process. Together with well-defined patient-based selection criteria, a change inmind set and amultidisciplinary approach, OS pathways are as safe and efficient as conventional pathways, in terms of readmissions, complications [8,14] and clinical outcome [12,13]. Conclusion With the present study, we are able to conclude that patients, who are selected according to strict criteria for inclusion in an outpatient knee arthroplasty pathway, have comparable quality of life and PROMs as patients operated in a conventional enhanced recovery pathway. Acknowledgements The authors would like to thank Miss. Elke Thijs for her work in collecting the raw data from the digital patient records. Author’s contribution Martijn G.M. Schotanus, designed the study, gathered and analysed all the data, wrote the initial draft of themanuscript andmanaged the study. Yoeri F.L. Bemelmans ensured the accuracy of the data, analyzed the data, wrote and revised the manuscript. Nanne P. Kort, conceived the study and revised the manuscript. Conflict of interest No benefits in any formhave been received or will be received froma commercial party related directly or indirectly to the subject of this article. One author (Nanne P. Kort) is a paid consultant for Zimmer-Biomet, Europe. The other authors certify that they have no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted manuscript.