A perioperative optimization program can improve results and reduce hospital length of stay in hip and knee arthroplasty: Experience in Chile

Background and objective: Perioperative optimization programs have been shown to improve outcomes in total hip and knee arthroplasty; however, the evidence in Latin America is limited. Our objective is to evaluate the impact of implementing a multidisciplinary optimization program in prosthetic surgery at a Latin American center. Materials and methods: A retrospective cohort study evaluating elective hip and knee prosthesis surgeries between 2016 and 2023 at a private hospital. We compared pre-intervention (2016–2018) and post-intervention (2019–2023) groups following the implementation of a multidisciplinary perioperative optimization program in 2019. The impact of the program on hospital length of stay and 90-day readmission rates was assessed. Results: A total of 1,462 patients (1,636 surgeries) were included, with 429 surgeries in the pre-intervention group and 1,207 in the post-intervention group. Hospital length of stay decreased from 3.5 to 2.22 days (p < 0.05). The 90-day readmission rate decreased from 2.56 to 2.24% (p = 0.71), with a significant reduction in knee arthrofibrosis (from 0.9 to 0.2%, p < 0.05). The optimization program was the main factor contributing to the reduction in hospital length of stay. Conclusions: The multidisciplinary perioperative program implemented significantly reduced hospital stay without increasing 90-day readmission rates. Furthermore, it equated outcomes between patients with public and private insurance.