Patient satisfaction and complications in patients undergoing primary knee arthroplasty managed with an outpatient surgery protocol between 2015 and 2016
DOI:
https://doi.org/10.1016/j.rccot.2017.08.007Keywords:
patient satisfaction, ambulatory care, arthroplasty, knee replacementAbstract
Background: Total Knee Replacement is classified as major orthopedic surgery, where several complications have been described. The study shows how this procedure managed with an ambulatory surgery protocol is safe for the patient and does not increase the frequency of complications.
Materials & Methods: Transverse cohort descriptive observational study. We included patients with ASA I-II classification, Body Mass Index < 35 and age < 80 years, who underwent total primary knee replacement with diagnosis of severe osteoarthritis. Information related to postoperative pain, patient satisfaction at the first postoperative visit and the presence of complications were collected within 30 days of the procedure.
Results: A total of 143 patients with anesthesia classification ASA I 19 patients (13.3%) y ASA II 124 (86.7%), 83 (58%) women y 60 (42%) men average age 66,6 (DS 9.2) years, average body mass index 27.3 (DS 3.6), Oxford knee score before surgery 33.3 (8.4), pain first day post surgery at rest 1,1 (DS 1,4) and with movement 2,5 (DS 1.8), average satisfaction of the surgery experience on an outpatient basis in an scale of 0 a 10 was 8.6 (DS1.5). There were 4 (2.8%) readmissions to the emergency room for reasons not related to the outpatient protocol.
Discussion: In selected patients, total knee replacement with outpatient surgery protocol is safe, increases comfort and satisfaction of patients and their families.
Evidence Level: III.
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References
Xu GG1, Sathappan SS, Jaipaul J, Chan SP, Lai CH. A review of clinical pathway data of 1,663 total knee arthroplasties in a tertiary institution in Singapore. Ann Acad Med Singapore. 2008;37:924. https://doi.org/10.47102/annals-acadmedsg.V37N11p924
Kurtz S, Ong K, Lau E, et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89:780. https://doi.org/10.2106/00004623-200704000-00012
Berger RA, Kusuma SK, Sanders SA, et al. The feasibility and perioperative complications of outpatient knee arthroplasty. Clin Orthop Relat Res. 2009;467:1443. https://doi.org/10.1007/s11999-009-0736-7
Huddleston JI, Maloney WJ, Wang Y, et al. Adverse events after total knee arthroplasty: a national Medicare study. J Arthroplasty. 2009;24 6 Suppl:95. https://doi.org/10.1016/j.arth.2009.05.001
Cook JR, WarrenM, Ganley KJ, et al. A comprehensive joint replacement program for total knee arthroplasty: a descriptive study. BMC Musculoskelet Disord. 2008;19:154. https://doi.org/10.1186/1471-2474-9-154
Guild GN, Galindo RP, Marino J, Cushner FD, Scuderi GR. Periarticular Regional Analgesia in Total Knee Arthroplasty. A Review of the Neuroanatomy and Injection Technique. Orthop Clin North Am. 2015;46:1-8. https://doi.org/10.1016/j.ocl.2014.09.016
Y-h K, J-w P, J-s K. The Clinical Outcome of Computer-Navigated Compared with Conventional Knee Arthroplasty in the Same Patients. 2017:989-96. https://doi.org/10.2106/JBJS.16.00791
16. CIA World Factbook - January, Enero 1, 2014.
Wier LM, Steiner CA, Owens PL. Surgeries in hospital-owned outpatient facilities, 2012. 2015:1-14.
Lovald ST, Ong KL, Malkani AL, Lau EC, Schmier JK, Kurtz SM, et al. Complications, mortality, and costs for outpatient and short-stay total knee arthroplasty patients in comparison to standard-stay patients. J Arthroplasty [Internet]. 2014;29:510-5. https://doi.org/10.1016/j.arth.2013.07.020
Berger RA1, Sanders S, Gerlinger T, Della Valle C, Jacobs JJ, Rosenberg AG. Outpatient Total Knee Arthroplasty With a Minimally Invasive Technique. J Arthroplasty. 2005;20 7 Suppl 3:33-8. https://doi.org/10.1016/j.arth.2005.05.021
Nwachukwu BU1, Bozic KJ, Schairer WW, Bernstein JL, Jevsevar DS, Marx RG, Padgett DE. Current Status of Cost Utility Analyses in Total Joint Arthroplasty: A Systematic Review Clin Orthop Relat Res. 2015;473:1815-27. https://doi.org/10.1007/s11999-014-3964-4
Peel TN, Cheng AC, Liew D, Buising KL, Lisik J, Carroll KA, Choong PFM, Dowaey MM. Direct Hospital Cost Determinants Following Hip and Knee Arthroplasty. Arthritis Care & Research. 2015;67:782-90. https://doi.org/10.1002/acr.22523
Cleary PD, Greenfield S, Mulley AG, Pauker SG, Schroeder SA, Wexler L, McNeil BJ. Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California. JAMA. 1991;266:73-9. https://doi.org/10.1001/jama.1991.03470010077034
Nwachukwu BU1, Bozic KJ, Schairer WW, Bernstein JL, Jevsevar DS, Marx RG, Padgett DE. Current Status of Cost Utility Analyses in Total Joint Arthroplasty: A Systematic Review Clin Orthop Relat Res. 2015;473:1815-27, 12. https://doi.org/10.1007/s11999-014-3964-4
Peel TN, Cheng AC, Liew D, Buising KL, Lisik J, Carroll KA, Choong PFM, Dowaey MM. Direct Hospital Cost Determinants Following Hip and Knee Arthroplasty. Arthritis Care & Research. 2015;67:782-90. https://doi.org/10.1002/acr.22523
