Can Same-Day Total Joint Arthroplasty Be An Everyday Surgery for Everyone? An Editorial Viewpoint

As the efficiency of total joint arthroplasty (TJA) continues to improve, there has been an increased focus on postoperative patient length of stay (LOS). Over the last 10 years, the literature has identified several factors that have brought same-day discharge after primary TJA into the forefront of the adult reconstruction world. Major advances in postoperative pain management [ [1] Lachiewicz P.F. Lee G.C. Pollak R.A. Leiman D.G. Hu J. Sah A.P. HTX-011 reduced pain and opioid use after primary total knee arthroplasty: results of a randomized phase 2b trial. J Arthroplasty. 2020; 35: 2843-2851 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , [2] Hyland S.J. Deliberato D.G. Fada R.A. Romanelli M.J. Collins C.L. Wasielewski R.C. Liposomal bupivacaine versus standard periarticular injection in total knee arthroplasty with regional anesthesia: a prospective randomized controlled trial. J Arthroplasty. 2019; 34: 488-494 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar ] and multimodal pain regimens [ 2 Hyland S.J. Deliberato D.G. Fada R.A. Romanelli M.J. Collins C.L. Wasielewski R.C. Liposomal bupivacaine versus standard periarticular injection in total knee arthroplasty with regional anesthesia: a prospective randomized controlled trial. J Arthroplasty. 2019; 34: 488-494 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar , 3 Lucero C.M. García-Mansilla A. Zanotti G. Comba F. Slullitel P.A. Buttaro M.A. A repeat dose of perioperative dexamethasone can effectively reduce pain, opioid requirement, time to ambulation, and in-hospital stay after total hip arthroplasty: a prospective randomized controlled trial. J Arthroplasty. 2021; 36: 3938-3944 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar , 4 Tammachote N. Kanitnate S. Intravenous dexamethasone injection reduces pain from 12 to 21 hours after total knee arthroplasty: a double-blind, randomized, placebo-controlled trial. J Arthroplasty. 2020; 35: 394-400 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar , 5 Hannon C.P. Fillingham Y.A. Browne J.A. Schemitsch E.H. Mullen K. Casambre F. et al. The efficacy and safety of gabapentinoids in total joint arthroplasty: systematic review and direct meta-analysis. J Arthroplasty. 2020; 35: 2730-2738.e6 Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar ] have facilitated accelerated discharge. Particularly, the recent SARS-CoV-2 (COVID-19) pandemic catapulted same-day discharge into the spotlight at a much faster rate than anticipated [ [6] Piple A.S. Wang J.C. Bouz G.J. Chung B.C. Mayfield C.K. Richardson M.K. et al. The persistent effects of the COVID-19 pandemic on total joint arthroplasty changes in practice patterns in the United States from 2020 to 2021. J Arthroplasty. 2023; 38: 1438-1443.e1 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar ].