Clinical pathway optimisation towards outpatient joint arthroplasty

On a global scale, hip and knee arthroplasty surgeries as treatment for end-stage osteoarthritis are increasingly performed, making these operations one of the most performed and successful orthopaedic surgeries. Improvement of outcomes after these surgeries is not solely based on the surgical procedure itself. In the past decades, the introduction of so-called clinical pathways improved postoperative outcomes in terms of safety and efficacy. A clinical pathway consists of a combination of pre-, peri- and postoperative protocols, which form the patients’ process (or journey) throughout their surgical procedure. The optimisations within these pathways are making it nowadays possible to discharge patients faster (within 2 days), and in selected populations even on the day of surgery.
The studies of the present thesis were performed to analyse several aspects of the implementation of clinical pathway features, to improve outcome after hip and knee arthroplasty. Additional aims for this thesis were to examine the safety and efficacy of the implementation of outpatient joint arthroplasty pathways into daily practice in a teaching hospital.