SAFETY AND EFFECTIVENESS OF A STAND-ALONE AMBULATORY CARE JOINT REPLACEMENT PROGRAMME
Bibliographic record
Abstract
To address the increasing demand of joint replacements as well as addressing the surgical backlog compounded by limited OR resources, a public-private partnership to subcontract bundle care for hip, knee and shoulder replacements was established. The purpose of this study is to assess the safety and effectiveness of a stand-alone ambulatory care joint replacement (ACJR) center. 329 arthroplasty procedures were performed as outpatient: 136 hips, 176 knees, and 17 shoulders since February 2023. 141 (43%) males and 188 (57%) females with a mean age of 66 years (36-88), mean BMI of 29 (18-52), and mean ASA of 2.34 (1 and 4). Outcomes included: failure to discharge on the day of surgery if the patient had a 90-day readmission if the patient had 48 hours, 7 Days, or 30 days ER visit from the time of surgery as well as patient-reported outcome measures (PROMs). PROMs measured included Oxford hip score (OHS), Oxford knee score (OKS), and PROMIS scores.&nbsp; Following surgery, two patients (<1%) underwent re-operation within 90 days. 9.2% of patients return to ER within 30 days (5.8% within 7 days and 1% within 48 hours). Out of these unexpected healthcare encounters, 2.5% were unrelated, 3.3% required medication adjustments and 6.7% were minor adverse events including minor bleeding, drainage, and pain. None of the ER visits required re-admission. The mean (SD) improvement in OHS was 16.3 (9.9), OKS was 13.1 (10.1) and PROMIS was 5.5 (6.03). A stand-alone ambulatory care joint replacement is a safe and effective method of reducing surgical wait times and improving the delivery of care to patients requiring joint replacement surgery. We hope that this study provides insight for other centres facing similar challenges.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".