ORIGINAL RESEARCH article

Front. Surg.

Sec. Orthopedic Surgery

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1597068

This article is part of the Research TopicDiagnosis and Treatment in Age-related musculoskeletal disordersView all 8 articles

Risk Factors Associated with the Failure of Day Surgery for Total Knee Arthroplasty A Multivariate Logistic Regression Analysis

Provisionally accepted
Pan  LuoPan Luo1Jiabin  FengJiabin Feng2Yankun  LiYankun Li1Yingli  ZouYingli Zou1Xuepeng  ZhuXuepeng Zhu1Li  SunLi Sun1Bo  LiBo Li1*
  • 1Department of Orthopedics, Guizhou Provincial People’s Hospital, Guiyang, China
  • 2Graduate School of Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou Province, China

The final, formatted version of the article will be published soon.

Objective: To explore and analyze the risk factors leading to delayed discharge in patients undergoing day surgery for total knee arthroplasty, providing a theoretical basis for optimizing patient selection, targeted interventions, and managing expectations and risks of day surgery patients.A retrospective analysis of clinical data from patients diagnosed with "knee osteoarthritis" and scheduled for day surgery for total knee arthroplasty at the Department of Orthopedics, Guizhou Provincial People's Hospital from October 2021 to June 2023. Patients were divided into a normal discharge group and a delayed discharge group based on whether their hospital stay exceeded 48 hours.Univariate analysis and multivariate logistic regression analysis were used to identify potential risk factors between the two groups.Results: Among the 233 patients scheduled for day surgery for total knee arthroplasty, 82 experienced delayed discharge. Univariate analysis showed that age (P=0.042), glomerular filtration rate (P=0.011), diabetes history (P=0.046), disease duration (P=0.012), knee flexion range of motion (P<0.001), knee flexion contracture degree (P=0.006), and surgery time (P=0.002) had statistically significant differences between the two groups. Multivariate logistic regression analysis revealed that disease duration (P=0.017), knee flexion range of motion (P<0.001), glomerular filtration rate (P=0.010), and surgery time (P=0.020) were independent risk factors. Additionally, postoperative motor function decline or sensory impairment, pain, dizziness or orthostatic hypotension, postoperative limb swelling, postoperative nausea and vomiting, bleeding and exudation, and psychosocial factors were the main reasons for delayed discharge.Our study found that disease duration, knee flexion range of motion, glomerular filtration rate, and surgery time are independent risk factors for delayed discharge after day surgery for total knee arthroplasty. Patients with a disease duration of more than 8 years, preoperative flexion range of motion less than 90°, and low estimated glomerular filtration rate may not be suitable for day surgery for total knee arthroplasty. Surgeons should make adequate preoperative preparations and plans, refine surgical skills, and shorten surgery time under the premise of ensuring surgical effects to reduce the risk of postoperative delayed discharge.

Keywords: day surgery, Delayed discharge, Joint arthroplasty, Knee Joint, Risk factors

Received: 20 Mar 2025; Accepted: 30 May 2025.

Copyright: © 2025 Luo, Feng, Li, Zou, Zhu, Sun and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Bo Li, Department of Orthopedics, Guizhou Provincial People’s Hospital, Guiyang, China

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