{
  "abstract": "Background\n\nDay-case hip and knee arthroplasty can reduce bed occupancy and improve cost-effectiveness, which is crucial for addressing the increasing demand among hip and knee osteoarthritis patients. This study investigated how different arthroplasty center setups were associated with the implementation and day-of-surgery (DOS) discharge rates of a standardized day-case setup.Materials and methods\n\nWe included unilateral primary hip and knee arthroplasty patients from seven fast-track arthroplasty centers, all implementing a standardized day-case setup in September 2022 with identical eligibility and discharge criteria. Centers were categorized as: Satellite Arthroplasty Centers (SACs): Only primary arthroplasties, separate logistics. Elective Arthroplasty Centers (EACs): Complex primaries, revisions, separate logistics. Arthroplasty Unit Orthopedic Departments (AUOs): Primary and revision procedures, integrated into a general orthopedic department. We compared DOS discharge rates from September 2022 to September 2023 with a baseline period (July 2019-December 2019) using crude percentages. We compared the DOS discharge rate for day-case-eligible patients in study period between the center types using mixed effects models.Results\n\nWe included 6718 patients (1357 SAC, 4309 EAC, 1052 AUO) during the study period and 3974 in the baseline period. DOS discharge rates increased post-implementation across all centers (SAC: 3.9% to 30%, EAC: 5.5% to 23%, AUO: 7.4% to 14%). Compared with AUOs (36%), successful DOS discharge among eligible patients was more likely in SACs (54%; adjusted OR 3.0, 95% CI 1.3-7.1; adjusted risk difference 25 percentage points, 95% CI 5.9-44) and EACs (60%; adjusted OR 3.8, 95% CI 1.7-8.5; adjusted risk difference 31 percentage points, 95% CI 13.8-48).Conclusions\n\nArthroplasty centers with logistics separate from the general orthopedic department, SACs and EACs, were associated with higher rates of successful DOS discharge among eligible patients during implementation of a standardized day-case pathway, despite integrated arthroplasty units, AUOs, having higher day-case surgery use before implementation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, Hvidovre University Hospital, Hvidovre, Denmark. christian.bredgaard.jensen@regionh.dk.",
    "Center for Fast-track Hip and Knee Replacement, Copenhagen, Denmark. christian.bredgaard.jensen@regionh.dk.",
    "Center for Fast-track Hip and Knee Replacement, Copenhagen, Denmark.",
    "Department of Orthopaedic Surgery and Traumatology, Odense University Hospital and Svendborg, Odense, Denmark.",
    "Department of Orthopaedic Surgery, Lillebaelt Hospital, Vejle, Vejle, Denmark.",
    "Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.",
    "Department of Orthopaedic Surgery, Copenhagen University Hospital Herlev-Gentofte, Gentofte, Denmark.",
    "Department of Orthopaedic Surgery, Næstved, Slagelse and Ringsted Hospitals, Næstved, Denmark.",
    "Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.",
    "Department of Anaesthesia, Hospital of Northern Zeeland, Hillerød, Hillerød, Denmark.",
    "Section of Surgical Pathophysiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.",
    "Department of Orthopaedic Surgery, Hvidovre University Hospital, Hvidovre, Denmark. kirill.gromov@regionh.dk.",
    "Center for Fast-track Hip and Knee Replacement, Copenhagen, Denmark. kirill.gromov@regionh.dk."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Christian Bredgaard Jensen"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Oddrún Danielsen"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Claus Varnum"
    },
    {
      "affs": [
        2,
        5
      ],
      "name": "Thomas Jakobsen"
    },
    {
      "affs": [
        2,
        6
      ],
      "name": "Mikkel Ratsach Andersen",
      "orcid": "0000-0003-3405-7147"
    },
    {
      "affs": [
        2,
        7
      ],
      "name": "Manuel Josef Bieder"
    },
    {
      "affs": [
        2,
        8
      ],
      "name": "Søren Overgaard"
    },
    {
      "affs": [
        2,
        9
      ],
      "name": "Christoffer Calov Jørgensen",
      "orcid": "0000-0001-6902-8181"
    },
    {
      "affs": [
        2,
        10
      ],
      "name": "Henrik Kehlet"
    },
    {
      "affs": [
        11,
        12
      ],
      "name": "Kirill Gromov"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/40n0n4gr3xnmv.bib",
  "cited_by": 0,
  "doi": "10.1007/s00402-026-06525-8",
  "fulltext_url": "https://europepmc.org/articles/PMC13719722",
  "id": "40n0n4gr3xnmv",
  "issns": [
    "0936-8051",
    "1434-3916"
  ],
  "landing_url": "https://europepmc.org/article/MED/42955362",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "3604|Healthcare Operations and Scheduling Optimization"
    ]
  ],
  "openalex": "W7224317405",
  "pdf_url": "https://europepmc.org/articles/PMC13719722?pdf=render",
  "pmcid": "PMC13719722",
  "pmid": "42955362",
  "published": "2026-10-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/40n0n4gr3xnmv.ris",
  "sources": [
    {
      "first_seen": "2026-11-01T00:20:36Z",
      "native_id": "MED:42955362",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42955362"
    },
    {
      "first_seen": "2026-11-02T12:23:38Z",
      "native_id": "PMC13719722",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00402-026-06525-8"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:2746|Orthopaedic implants and arthroplasty",
      "subfield": "surgery"
    }
  ],
  "title": "Arthroplasty centers logistically separated from general orthopedic departments were associated with a more successful implementation of a standardized day-case setup : A Danish cohort study of 6718 procedures from a fast-track multi-center collaboration.",
  "title_text": "Arthroplasty centers logistically separated from general orthopedic departments were associated with a more successful implementation of a standardized day-case setup : A Danish cohort study of 6718 procedures from a fast-track multi-center collaboration.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:20:44Z",
  "url": "https://research.draconitic.com/paper/40n0n4gr3xnmv",
  "venue": "Archives of orthopaedic and trauma surgery",
  "versions": []
}