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The development of a day case arthroplasty service in a district general hospital setting

Kartigan Nathan

Suraj Kohli1, Susie Baker2, Colin Senior2, Louise McMenemey2, Owen Mitchell2, Kartigan Nathan1
1UHS, Southampton, United Kingdom. 2Dorset County Foundation Trust, Dorset, United Kingdom


Hospital inpatient stay following arthroplasty has reduced substantially over the past decade and is associated with improved patient outcomes and satisfaction. This study aimed to assess the day case arthroplasty service at a district general hospital (Dorset County Hospital).


Patients were identified in orthopaedic outpatients as being appropriate for day case and were referred onto a specialist anaesthetic assessment service. This service confirms suitability for day case arthroplasty and preoperatively prepares patients for day case. On the day, patients are admitted and follow standardised anaesthetic and post-operative protocols. Data was then collected on type of anaesthetic, procedure, date of discharge, and reasons for delay in discharge.


From October 2022 to April 2023, 49 cases were identified, (20 TKRs, 27 THRs, and 1 reverse shoulder replacement). 58% of THRs (16/27), 20 % of TKRS (4/20), and all shoulders went home the same day. 29% of patients were not mobilised within the first 4-6 hours and only 7% of those patients were discharged the same day. 56% of the patients who were not mobilised within the first 4-6 hours was due to the spinal still being in effect. 82% of all patients had a spinal anaesthetic.


Although there are still some challenges that need to be overcome such as an increase in physiotherapy cover out of hours, day-case arthroplasty is a feasible pathway that can be introduced in a short time span. Patients who underwent THRs were more likely to be successful than TKRs for same day discharges.