Abstract
High tibial osteotomy (HTO) is largely conducted as an inpatient procedure, imposing the significant cost of hospital admission. Here we examine patient-related outcomes and cost benefit of altering HTO to a day-case procedure.
A retrospective questionnaire was conducted with patients that underwent HTO in the one and half years prior to the change to day-case, and those in the one and half years afterwards. We considered pre-operative and post-operative KOOS scores, patient pain-scoring and whether they would, given their experience, undergo HTO as an outpatient again.
Thirty-three patients were included in the trial: twenty-three inpatient admissions and ten day-cases.
Average KOOS score improvement for inpatients was 24.68 and outpatients was 31.8. Outcomes such as post-operative pain and nausea/vomiting were found to be similar between groups. The outpatient group unanimously agreed that if undergoing HTO again they would desire to be treated in the outpatient setting again.
Currently HTO is conducted as an inpatient procedure in the majority of institutions. We have demonstrated that patients have comparable outcomes and agree that if undergoing HTO again they would wish to do so as day-case outpatient. This represents a significant cost saving for institutions conducting HTO as well as an improvement in service.
