Image by Nattanan Kanchanaprat from PixabayA study presented at the American Association of Hip and Knee Surgeons (AAHKS) Annual Meeting in late 2025 found that patients undergoing revision of total joint replacement (TJR) may experience fewer postoperative complications when the procedure is performed at a standalone ambulatory surgery center (ASC) rather than in a hospital setting.
The AAHKS annual meeting took place Oct. 23-26 in Dallas.
Dr. Craig J. Della Valle, endowed professor of orthopedic surgery and chief of adult reconstruction at Chicago’s Rush University Medical Center, presented a paper based on data from 586 patients undergoing aseptic revision TJR at Rush, whether at an ASC or in an inpatient hospital, between 2015 and 2024.
Researchers gathered data on medical and surgical complications, reoperations and revisions within 90 days after surgery.
Della Valle noticed a selection bias among patients who had surgery at standalone ASCs rather than the main hospital.
“The outpatient cohort was younger, less medically complex and had higher instances of revision knee replacement compared to hip replacement,” Della Valle told Ambulatory Surgery Center News. “We were able to compensate for that statistically.”
Patients who had the surgery as inpatients experienced higher rates of transfusion and medical complications. Those who had the surgery on an outpatient basis had fewer complications.
Ideally, Della Valle said, when considering a patient for a revision TJR in an ASC, surgeons should consider the same factors they would for a primary replacement.
“The patient should have a strong social support network, no comorbidities and it should be a procedure the surgeon feels comfortable performing in this setting,” he advised.
At 90 days postoperatively, Della Valle and researchers found that patients undergoing revision TJR in the ASC had a reduced risk of any medical complication, periprosthetic joint infection, reoperation and emergency room visits. Patients who underwent a modular component exchange in an ASC had a lower risk of complications than those undergoing the procedure in the inpatient setting.
He also noted that patients who underwent a revision TJR for instability had a decreased risk for reoperation and any complications.
“As long as you have a reasonable patient and are comfortable performing the procedure in the outpatient setting, those cases are amenable to being done at a free-standing ASC,” he said.
The paper is currently under peer review and has not yet been published.
