Preoperative Patient-Recorded Outcome Measures Predict Patient Discharge Location Following Unicondylar Knee Arthroplasty.
Advantages of unicondylar knee arthroplasty (UKA) over total knee arthroplasty include rapid recovery and shorter lengths of stay following surgery. Patients requiring extended postoperative care fail to recognize these benefits. Patient-reported outcome measures have proved useful in predicting outcomes following joint arthroplasty. The purpose of this study was to identify and report preoperative patient-reported outcome measures and clinical variables that predict discharge to skilled nursing facilities following UKA.



A prospective cohort of 174 patients was used to collect 36-Item Short Form scores and objective clinical data. Univariate and multivariate analysis with backward elimination were conducted to find a predictive risk model.



The predictive model reported (78.7% concordance, receiver operating characteristic curve c-statistic 0.719, P = .0016) demonstrates that risk factors for discharge to skilled nursing facilities are: older age (odds ratio 4.18; 95% confidence interval [CI] 1.256-13.911, P = .019), bilateral UKA procedures (odds ratio 1.887; 95% CI 1.054-3.378, P = .0326) and lower patient-reported preoperative 36-Item Short Form physical function scores (odds ratio 0.968; CI 0.938-1, P = .0488).



The information presented here regarding possible patient disposition following UKA could aid informed decision-making regarding patients' short-term needs following surgery and help streamline preoperative planning.
Department of Orthopaedic Surgery, University of Arizona College of Medicine, Tucson, Arizona.
Alfonso E
AE
Ayala
Department of Orthopaedic Surgery, University of Arizona College of Medicine, Tucson, Arizona.
Kevin A
KA
Lawson
Mel and Enid College of Public Health, University of Arizona, Tucson, Arizona.
Angelika C
AC
Gruessner
Department of Orthopaedic Surgery, University of Arizona College of Medicine, Tucson, Arizona.
Michael P
MP
Dohm
The Western Slope Study Group, Loma, Colorado.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D000071066:Patient Reported Outcome Measures; D011182:Postoperative Care; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012866:Skilled Nursing Facilities; D011795:Surveys and Questionnaires
discharge location; patient reported outcome measures; postoperative planning; skilled nursing facility; unicondylar knee arthroplasty