İsmet Köksal1, Mesut Tahta2, Mehmet Emin Şimşek3, Metin Doğan4, Murat Bozkurt4. 1. Yenimahalle State Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey. ismetkoksal@hotmail.com. 2. Atatürk Training and Research Hospital, Department of Orthopaedics and Traumatology, İzmir, Turkey. 3. Atatürk Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey. 4. Yıldırım Beyazıt University Faculty of Medicine, Atatürk Training and Research Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey.
Abstract
OBJECTIVE: Our aim was to compare the clinical results and cost-effectiveness of a rapid recovery protocol for total knee arthroplasty (TKA) with a current standard protocol. METHODS: The study included patients undergoing primary elective TKA with at least 6 months of follow-up. The rapid recovery protocol was applied to 96 patients (Group 1) and the standard protocol to 108 (Group 2). All patients underwent standard TKA. All pre-, peri-, and postoperative procedures in the treatment and follow-up of patients were appropriately standardized to the philosophies of the different treatment plans. The postoperative length of hospital stay, total financial cost, postoperative surgical infection, 6-month American Knee Society scores, and knee range of motion (ROM) were compared between the groups. RESULTS: A total of 169 patients were included. Group 1 patients had significantly shorter postoperative length of hospital stay (p=0.021), significantly lower mean total financial cost (p=0.041), significantly lower infection rates (p=0.034), and significantly higher 6-month knee function scores (p=0.032). In comparison with Group 2, Group 1 knee flexion (p=0.04) and extension (p=0.48) ROM at 6 months postoperatively were both significantly improved. CONCLUSION: Application of the rapid recovery protocol to patients who underwent TKA reduced costs and infection rates and improved functional results.
OBJECTIVE: Our aim was to compare the clinical results and cost-effectiveness of a rapid recovery protocol for total knee arthroplasty (TKA) with a current standard protocol. METHODS: The study included patients undergoing primary elective TKA with at least 6 months of follow-up. The rapid recovery protocol was applied to 96 patients (Group 1) and the standard protocol to 108 (Group 2). All patients underwent standard TKA. All pre-, peri-, and postoperative procedures in the treatment and follow-up of patients were appropriately standardized to the philosophies of the different treatment plans. The postoperative length of hospital stay, total financial cost, postoperative surgical infection, 6-month American Knee Society scores, and knee range of motion (ROM) were compared between the groups. RESULTS: A total of 169 patients were included. Group 1 patients had significantly shorter postoperative length of hospital stay (p=0.021), significantly lower mean total financial cost (p=0.041), significantly lower infection rates (p=0.034), and significantly higher 6-month knee function scores (p=0.032). In comparison with Group 2, Group 1 knee flexion (p=0.04) and extension (p=0.48) ROM at 6 months postoperatively were both significantly improved. CONCLUSION: Application of the rapid recovery protocol to patients who underwent TKA reduced costs and infection rates and improved functional results.
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