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Advances in Orthopedics
Volume 2016 (2016), Article ID 1424193, 6 pages
Research Article

Day of Surgery Admission in Total Joint Arthroplasty: Why Are Surgeries Cancelled? An Analysis of 3195 Planned Procedures and 114 Cancellations

1University Hospital Limerick, Limerick, Ireland
2Cappagh National Orthopaedic Hospital, Dublin, Ireland
3Sunnybrook Hospital, Toronto, ON, Canada
4Kilcreene Orthopaedic Hospital, Kilkenny, Ireland
5Our Lady of Lourdes Hospital, Drogheda, Ireland

Received 26 July 2016; Accepted 18 October 2016

Academic Editor: Elizaveta Kon

Copyright © 2016 David M. Dalton et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Day of surgery admission (DOSA) is becoming standard practice as a means of reducing cost in total joint arthroplasty. Aims. The aim of our study was to audit the use of DOSA in a specialty hospital and identify reasons for cancellation. Methods. A retrospective study of patients presenting for hip or knee arthroplasty between 2008 and 2013 was performed. All patients were assessed at the preoperative assessment clinic (PAC). Results. Of 3195 patients deemed fit for surgery, 114 patients (3.5%) had their surgery cancelled. Ninety-two cancellations (80%) were due to the patient being deemed medically unsuitable for surgery by the anaesthetist. Cardiac disease was the most common reason for cancellation (), followed by pulmonary disease (). 77 patients (67.5%) had their operation rescheduled and successfully performed in our institution at a later date. Conclusion. DOSA is associated with a low rate of cancellations on the day of surgery. Patients with cardiorespiratory comorbidities are at greatest risk of cancellation.