Orthostatic intolerance affects up to 52% of patients following total joint arthroplasty and remains a significant barrier to successful same-day discharge, with no conclusively proven treatments.
Orthostatic intolerance is a highly prevalent complication following total joint arthroplasty that hinders same-day discharge, with multiple patient and surgical risk factors identified but no conclusively proven treatments.
Early mobilisation following total joint arthroplasty is crucial in considering patients for successful same-day discharge (SDD). Recent years have seen an increase in SDD after total joint arthroplasty, with complication rates comparable to those with prolonged hospital stays. Orthostatic intolerance (OI) is a significant barrier to successful SDD after total hip and knee arthroplasties, with up to 52% of patients experiencing it. Patient-related factors include being female, being elderly, having multiple comorbidities, possessing a higher American Society of Anesthesiologists (ASA) status, experiencing pain levels exceeding 5/10, and using gabapentin. Surgery-related risk factors identified were spinal anaesthesia versus general anaesthesia, hip replacement versus knee replacement, and postoperative opioid use. Non-pharmacological and pharmacological approaches can be used to categorise management strategies. However, no treatment has conclusively proven to address OI fully.
Kyei et al. (Mon,) conducted a review in Orthostatic intolerance following total joint arthroplasty. Total joint arthroplasty was evaluated on Orthostatic intolerance. Orthostatic intolerance affects up to 52% of patients following total joint arthroplasty and remains a significant barrier to successful same-day discharge, with no conclusively proven treatments.
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