24 Hours of Postoperative Oral Antibiotics for Same-Day Discharge After Hip and Knee Arthroplasty has Low Rate of Prosthetic Joint Infection

Title: 24 Hours of Postoperative Oral Antibiotics for Same-Day Discharge After Hip and Knee Arthroplasty Has Low Rate of Prosthetic Joint Infection Authors: Phillip C. McKegg, MS, Colton Clymer, BS, Hamza Raja, BS, Alexander Driessche, MSE, Gabriel Boudagh, BS, W. Trevor North, MD, Michael A. Charters, MD Introduction: There is no clear consensus on postoperative antibiotic protocols for same-day discharge hip and knee arthroplasties. This study evaluates prosthetic joint infection (PJI) rates in patients discharged with 24 hours of oral antibiotics after surgery. Methods: A retrospective review was conducted on 1,843 patients who underwent primary hip or knee arthroplasty at two ambulatory surgery centers from 2021 to 2023. Data were collected from patient charts and the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI). All received 24 hours of postoperative oral antibiotics. The primary outcome was PJI within 90 days. Chi-squared tests were used for analysis. Results: The cohort included 1,052 knee (57.1%) and 638 hip (34.7%) arthroplasties. Median age was 66 years, and median BMI was 31.02 kg/m². PJI occurred in 5 patients (0.3%): 3 after total hip arthroplasty (THA) and 2 after total knee arthroplasty (TKA). No significant differences in PJI rates were found based on gender, BMI, smoking status, diabetes, or procedure type (p>0.05). Conclusion: A 24-hour course of postoperative oral antibiotics after same-day discharge THA and TKA was associated with a low PJI rate. This approach may reduce PJI risks, healthcare costs, and complications, supporting its use in postoperative care protocols.