4 key points on appropriate patient selection for total joint replacement in ASCs

Laura Dyrda -

A new study published in the Journal of Arthroplasty examines the factors that could disqualify patients for total joint replacements in ASCs.

Study authors examined 3,444 patients who underwent total joint replacements and assigned ASC eligibility based on factors that include American Society of Anesthesiologists status and comorbidities. Their key findings include:

1. More than 70 percent of the patients fit ASC eligibility.

2. Of the patients who were ASA III class and had systemic disease — which accounts for roughly half of all ASA III patients — but didn't meet any other exclusion criteria, 53.7 percent were considered ASC-eligible due low comorbidity severity.

3. The factors most associated with ineligibility for the ASC include:

• BMI over 40: 32.6 percent
• Comorbidity severity: 28 percent
• Untreated obstructive sleep apnea: 25 percent

4. Study authors concluded, "ASC performed TJA provides an opportunity for increased patient satisfaction and decreased costs, selecting the right candidates for the ambulatory setting is critical to maintain patient safety and avoid postoperative complications."

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