Hutzler L et al. – This study evaluated the percentage of patients with arthroplasty who are eligible for total joint arthroplasties (TJAs) performed in a free–standing ambulatory surgery centers (ASC) and also analyzed the comorbidities that disqualifies patients for ASC. The study reported that large proportion of TJA patients which includes one–third of American society of anesthesiologist (ASA) class 3 patients were eligible for surgery in an ASC which has the potential for increased patient satisfaction and decreased costs. Therefore, it is important that right candidates are selected for ambulatory care to maintain patient safety and better postoperative outcomes.

Methods

• The charts were reviewed for 3,444 patients undergoing TJA and assigned ASC eligibility based on ASA status, exclusion criteria, and underlying comorbidities.

Results

• In total , 70.03% patients undergoing TJA were eligible for ASC.
• Of the ASA class 3 patients who did not meet any exclusion criteria but had systemic disease (51.11% of all ASA class 3 patients), 53.69% were ASC–eligible due to low severity of comorbidities.
• Common reasons for ineligibility were body mass index greater than 40 (32.66% of ineligible patients), severity of comorbidities (28.00%), and untreated obstructed sleep apnea (25.19%).