Preoperative Oral Hydration in the Ambulatory Arthroplasty Population

The way total joint arthroplasty is practiced continues to evolve as CMS removed total hip arthroplasty (THA) from the inpatient-only list and added total knee arthroplasty (TKA) to the ASC Covered Surgical Procedures List (CPL) in 2020. Thus, surgeons must find subtle interventions that improve patient outcomes while minimizing the risk of adverse reactions. Current literature has not assessed the influence of preoperative hydration, using a complex carbohydrate drink, on the same-day discharge rate and causes for failure to launch. Considering variabilities in perioperative fluid management leading to postoperative nausea, vomiting, and dizziness, the investigators seek to reduce the incidence of these events by optimizing patients using a preoperative oral hydration protocol, reducing the length of stay, and improving same-day discharge rates.

• Same day discharge rate [Time frame: Through study completion, an average of 3 months.]
• Number of physical therapy sessions attempted [Time frame: From admission to discharge, up to 1 week.]
• Total distance walked [Time frame: From admission to discharge, up to 1 week.]
• Number of stairs climbed [Time frame: From admission to discharge, up to 1 week.]
• Orthostatic hypotension episodes [Time frame: During physical therapy attempts, from admission to discharge.]
• HOOS JR Score [Time frame: The morning of surgery and at the first post-operative visit, up to 4 months post-op.]
• KOOS JR Score [Time frame: The morning of surgery and at the first post-operative visit, up to 4 months post-op.]
• VR-12 Score [Time frame: The morning of surgery and at the first post-operative visit, up to 4 months post-op.]
• Urine osmolality [Time frame: Measured preoperatively the morning of surgery.]
• Urine specific gravity [Time frame: Measured preoperatively the morning of surgery.]
• In-house costs [Time frame: From admission to discharge, up to 1 week.]