Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

Oddrún Danielsen; Kirill Gromov; Claus Varnum; Thomas H Jakobsen; Mikkel Rathsach Andersen; Manuel J Bieder; Christoffer C Jørgensen; Henrik Kehlet; Martin Lindberg-Larsen

doi:10.1302/2633-1462.69.BJO-2025-0109.R1

Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

Oddrún Danielsen^*
, Kirill Gromov
, Claus Varnum
, Thomas H Jakobsen
, Mikkel Rathsach Andersen
, Manuel J Bieder
, Christoffer C Jørgensen
, Henrik Kehlet
, Martin Lindberg-Larsen

^*Corresponding author for this work

Orthopaedic Surgery (NSR)

Research output: Contribution to journal › Article › Research › peer-review

Abstract

AIMS: The limited documentation on patients' perspectives on undergoing discharge on the day of surgery impedes its adoption as a standard of care. Hence, the aim of this study was to investigate whether patients were willing to repeat being discharged on the day of surgery if having a future hip or knee arthroplasty procedure.

METHODS: This multicentre, prospective consecutive cohort study spanned from 1 September 2022 to 31 January 2024, and was conducted at six public arthroplasty centres adhering to the same published protocol for discharge on the day of surgery following hip and knee arthroplasty. Patients undergoing primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (mUKA) were screened for eligibility and discharged when fulfilling predetermined discharge criteria. Patients discharged on the same calendar day of surgery were sent a questionnaire 30 days postoperatively.

RESULTS: Of 9,542 primary hip and knee arthroplasties registered, 3,457 (36%) were eligible for discharge on day of surgery; 58% of eligible patients (n = 2,011) were discharged on day of surgery and therefore received the survey. Baseline characteristics were comparable across all arthroplasty groups. The survey response rate was 88% (n = 1,771). Overall, 90% (95% CI 88 to 91) were willing to repeat discharge on the day of surgery if having a future joint arthroplasty, with 91% (95% CI 88 to 93) after THA, 89% (95% CI 86 to 92) after TKA, and 90% (95% CI 86 to 92) after mUKA. The difference between centres ranged from 84% to 93%. Patients responding 'no' to repeat discharge on the day of surgery were more often female (55%, n = 95) compared to patients responding 'yes' (47%, n = 744); otherwise, the groups were comparable.

CONCLUSION: A total of 90% of patients (n = 1,590) discharged on the day of surgery following hip and knee arthroplasty expressed willingness to repeat discharge on the day of surgery. This supports further implementation efforts.

Original language	English
Pages (from-to)	1156-1163
Number of pages	8
Journal	Bone & joint open
Volume	6
Issue number	9
DOIs	https://doi.org/10.1302/2633-1462.69.BJO-2025-0109.R1
Publication status	Published - 26 Sept 2025

Funding

The author (s) disclose receipt of the following financial or material support for the research, authorship, and/or publication of this article: in 2021, funding for the collaboration "The Center for Fast-track Hip and Knee Replacement" was secured from the Novo Nordisk Foundation (Grant number: NNF21SA0073760) . This funding provided for research staff at all participating centres, data management, and monitoring of complications. O. Danielsen's PhD salary was provided through funding from the Candys Foundation, University of Southern Denmark and Region of Southern Denmark.

Funders	Funder number
Novo Nordisk Foundation	NNF21SA0073760
Candy Foundation
University of Southern Denmark
Region of Southern Denmark

Keywords

Fast-track hip
Care
Replacement

Access to Document

10.1302/2633-1462.69.BJO-2025-0109.R1

Cite this

@article{3250b8286ba147b78d2ed164278f7038,

title = "Willingness to repeat discharge on day of surgery after hip and knee arthroplasty",

abstract = "AIMS: The limited documentation on patients' perspectives on undergoing discharge on the day of surgery impedes its adoption as a standard of care. Hence, the aim of this study was to investigate whether patients were willing to repeat being discharged on the day of surgery if having a future hip or knee arthroplasty procedure.METHODS: This multicentre, prospective consecutive cohort study spanned from 1 September 2022 to 31 January 2024, and was conducted at six public arthroplasty centres adhering to the same published protocol for discharge on the day of surgery following hip and knee arthroplasty. Patients undergoing primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (mUKA) were screened for eligibility and discharged when fulfilling predetermined discharge criteria. Patients discharged on the same calendar day of surgery were sent a questionnaire 30 days postoperatively.RESULTS: Of 9,542 primary hip and knee arthroplasties registered, 3,457 (36\%) were eligible for discharge on day of surgery; 58\% of eligible patients (n = 2,011) were discharged on day of surgery and therefore received the survey. Baseline characteristics were comparable across all arthroplasty groups. The survey response rate was 88\% (n = 1,771). Overall, 90\% (95\% CI 88 to 91) were willing to repeat discharge on the day of surgery if having a future joint arthroplasty, with 91\% (95\% CI 88 to 93) after THA, 89\% (95\% CI 86 to 92) after TKA, and 90\% (95\% CI 86 to 92) after mUKA. The difference between centres ranged from 84\% to 93\%. Patients responding 'no' to repeat discharge on the day of surgery were more often female (55\%, n = 95) compared to patients responding 'yes' (47\%, n = 744); otherwise, the groups were comparable.CONCLUSION: A total of 90\% of patients (n = 1,590) discharged on the day of surgery following hip and knee arthroplasty expressed willingness to repeat discharge on the day of surgery. This supports further implementation efforts.",

keywords = "Fast-track hip, Care, Replacement",

author = "Oddr{\'u}n Danielsen and Kirill Gromov and Claus Varnum and Jakobsen, \{Thomas H\} and \{Rathsach Andersen\}, Mikkel and Bieder, \{Manuel J\} and J{\o}rgensen, \{Christoffer C\} and Henrik Kehlet and Martin Lindberg-Larsen",

note = "{\textcopyright} 2025 Danielsen et al.",

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doi = "10.1302/2633-1462.69.BJO-2025-0109.R1",

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volume = "6",

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T1 - Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

AU - Danielsen, Oddrún

AU - Gromov, Kirill

AU - Varnum, Claus

AU - Jakobsen, Thomas H

AU - Rathsach Andersen, Mikkel

AU - Bieder, Manuel J

AU - Jørgensen, Christoffer C

AU - Kehlet, Henrik

AU - Lindberg-Larsen, Martin

PY - 2025/9/26

Y1 - 2025/9/26

N2 - AIMS: The limited documentation on patients' perspectives on undergoing discharge on the day of surgery impedes its adoption as a standard of care. Hence, the aim of this study was to investigate whether patients were willing to repeat being discharged on the day of surgery if having a future hip or knee arthroplasty procedure.METHODS: This multicentre, prospective consecutive cohort study spanned from 1 September 2022 to 31 January 2024, and was conducted at six public arthroplasty centres adhering to the same published protocol for discharge on the day of surgery following hip and knee arthroplasty. Patients undergoing primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (mUKA) were screened for eligibility and discharged when fulfilling predetermined discharge criteria. Patients discharged on the same calendar day of surgery were sent a questionnaire 30 days postoperatively.RESULTS: Of 9,542 primary hip and knee arthroplasties registered, 3,457 (36%) were eligible for discharge on day of surgery; 58% of eligible patients (n = 2,011) were discharged on day of surgery and therefore received the survey. Baseline characteristics were comparable across all arthroplasty groups. The survey response rate was 88% (n = 1,771). Overall, 90% (95% CI 88 to 91) were willing to repeat discharge on the day of surgery if having a future joint arthroplasty, with 91% (95% CI 88 to 93) after THA, 89% (95% CI 86 to 92) after TKA, and 90% (95% CI 86 to 92) after mUKA. The difference between centres ranged from 84% to 93%. Patients responding 'no' to repeat discharge on the day of surgery were more often female (55%, n = 95) compared to patients responding 'yes' (47%, n = 744); otherwise, the groups were comparable.CONCLUSION: A total of 90% of patients (n = 1,590) discharged on the day of surgery following hip and knee arthroplasty expressed willingness to repeat discharge on the day of surgery. This supports further implementation efforts.

AB - AIMS: The limited documentation on patients' perspectives on undergoing discharge on the day of surgery impedes its adoption as a standard of care. Hence, the aim of this study was to investigate whether patients were willing to repeat being discharged on the day of surgery if having a future hip or knee arthroplasty procedure.METHODS: This multicentre, prospective consecutive cohort study spanned from 1 September 2022 to 31 January 2024, and was conducted at six public arthroplasty centres adhering to the same published protocol for discharge on the day of surgery following hip and knee arthroplasty. Patients undergoing primary total hip arthroplasty (THA), total knee arthroplasty (TKA), or medial unicompartmental knee arthroplasty (mUKA) were screened for eligibility and discharged when fulfilling predetermined discharge criteria. Patients discharged on the same calendar day of surgery were sent a questionnaire 30 days postoperatively.RESULTS: Of 9,542 primary hip and knee arthroplasties registered, 3,457 (36%) were eligible for discharge on day of surgery; 58% of eligible patients (n = 2,011) were discharged on day of surgery and therefore received the survey. Baseline characteristics were comparable across all arthroplasty groups. The survey response rate was 88% (n = 1,771). Overall, 90% (95% CI 88 to 91) were willing to repeat discharge on the day of surgery if having a future joint arthroplasty, with 91% (95% CI 88 to 93) after THA, 89% (95% CI 86 to 92) after TKA, and 90% (95% CI 86 to 92) after mUKA. The difference between centres ranged from 84% to 93%. Patients responding 'no' to repeat discharge on the day of surgery were more often female (55%, n = 95) compared to patients responding 'yes' (47%, n = 744); otherwise, the groups were comparable.CONCLUSION: A total of 90% of patients (n = 1,590) discharged on the day of surgery following hip and knee arthroplasty expressed willingness to repeat discharge on the day of surgery. This supports further implementation efforts.

KW - Fast-track hip

KW - Care

KW - Replacement

U2 - 10.1302/2633-1462.69.BJO-2025-0109.R1

DO - 10.1302/2633-1462.69.BJO-2025-0109.R1

M3 - Article

C2 - 41002083

SN - 2633-1462

VL - 6

SP - 1156

EP - 1163

JO - Bone & joint open

JF - Bone & joint open

IS - 9

ER -

Willingness to repeat discharge on day of surgery after hip and knee arthroplasty

Abstract

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