Abstract
BACKGROUND: While same-day discharge models for knee arthroplasty have gained significant traction in China's evolving healthcare landscape, patient perspectives on ambulatory surgical pathways remain underexplored. This qualitative study addresses a critical gap in the literature by systematically assessing patient experiences and perceptions regarding knee arthroplasty within China's emerging ambulatory care framework. METHODS: A prospective cohort of 195 consecutive patients scheduled for primary knee arthroplasty at a tertiary orthopedic referral center underwent structured data collection through the WenJuanXing platform between January 1 and June 1, 2024. This cross-sectional survey employed an anonymous voluntary survey instrument administered at two critical timepoints: 1) prior to any clinical discussions regarding postoperative care pathways, and 2) before initiation of standardized preoperative education protocols. RESULTS: In total, 188 participants (96%, 188/195) completed the survey. Of them, 70% were female and 84% were 60 years or older. While 68% were familiar with ambulatory surgery, awareness did not significantly differ by age (P = 0.64), sex (P = 0.19), occupation (P = 0.42), location (P = 0.55), or education level (P = 0.81). Interestingly, only 8 patients anticipated discharge within 24 h post-surgery, with most (71.8%) expecting a 3-day or more stay. However, if postoperative care was assured, 66% expressed comfort with same-day or 24-h discharge. 93% considered ambulatory knee arthroplasty suitable, and 71.8% believed it would yield superior outcomes through quicker recovery and reduced complications, infections, and pain. Despite this optimism, only 45% were willing to endure longer waits, and a third were open to paying more or traveling farther for ambulatory knee arthroplasty. CONCLUSION: The study reveals that most Chinese patients initially want ≥ 3-day stays but may accept 24-h discharge for knee arthroplasty. One-third are unaware of ambulatory knee arthroplasty, so more education is needed as procedures rise.