Jean-Yves Jenny1, Cyril Courtin2, Philippe Boisrenoult3, Julien Chouteau4, Pierre Henky5, Claude Schwartz6, Aymard de Ladoucette7. 1. University Hospital Strasbourg, Pôle Locomax, 1 Avenue, Molière, 67200, Strasbourg, France. jean-yves.jenny@chru-strasbourg.fr. 2. Hospices Civils de Lyon, 3 quai des Célestins, 69001, Lyon, France. 3. Centre Hospitalier de Versailles, 177 rue de Versailles, 78150, Le Chesnay, France. 4. Clinique d'Argonay, 685 route des Menthonnex, 74370, Argonay, France. 5. Clinique Rhéna, 10 rue François Epailly, 67000, Strasbourg, France. 6. Polyclinique des Trois Frontières, 8 rue Saint-Damien, 68300, Saint-Louis, France. 7. Clinique de l'Union, Boulevard Ratalens, 31240, Saint-Jean, France.
Abstract
PURPOSE: The aim of this study was to evaluate the impact of fast-track procedures (FTPs) on length of hospital stay after primary total knee arthroplasty (TKA) in a prospective, national, multicentric analysis. The innovative point was that no patient selection was used. The hypothesis was that FTPs reduce hospital stay after primary TKA for non-traumatic conditions compared with the national database. METHODS: An observational prospective study was conducted in ten centres throughout France. A total of 839 patients included in FTPs were followed up for three months. The average LOS, direct return home rate, unscheduled re-admission rate, and re-intervention rate were compared with those in the national database (93,329 TKAs). Knee society and Oxford score were collected. RESULTS: The mean LOS was 4.4 ± 3.3 days, while the national base LOS was 6.4 ± 3.1 days (p < 0.001). A total of 560 patients (66.7%) were able to return home, compared with 47,617 (49.6%) in the national database (p < 0.001). Thirty-five patients (4.2%) were re-admitted within 90 days of the intervention, compared with 10,399 (10.8%) in the national database (p < 0.001). Seventeen patients (2.0%) were re-operated upon within 90 days after the TKA, compared with 529 (0.5%) in the national database (p < 0.05). CONCLUSION: The FTPs used by unselected patients allowed a significant decrease in the mean LOS and in the rate of re-admission and a significant increase of the rate of direct home return after primary TKA compared with the national database. The significant increase in the re-operation rate warrants further investigation. However, FTP should become the standard of care after this intervention.
PURPOSE: The aim of this study was to evaluate the impact of fast-track procedures (FTPs) on length of hospital stay after primary total knee arthroplasty (TKA) in a prospective, national, multicentric analysis. The innovative point was that no patient selection was used. The hypothesis was that FTPs reduce hospital stay after primary TKA for non-traumatic conditions compared with the national database. METHODS: An observational prospective study was conducted in ten centres throughout France. A total of 839 patients included in FTPs were followed up for three months. The average LOS, direct return home rate, unscheduled re-admission rate, and re-intervention rate were compared with those in the national database (93,329 TKAs). Knee society and Oxford score were collected. RESULTS: The mean LOS was 4.4 ± 3.3 days, while the national base LOS was 6.4 ± 3.1 days (p < 0.001). A total of 560 patients (66.7%) were able to return home, compared with 47,617 (49.6%) in the national database (p < 0.001). Thirty-five patients (4.2%) were re-admitted within 90 days of the intervention, compared with 10,399 (10.8%) in the national database (p < 0.001). Seventeen patients (2.0%) were re-operated upon within 90 days after the TKA, compared with 529 (0.5%) in the national database (p < 0.05). CONCLUSION: The FTPs used by unselected patients allowed a significant decrease in the mean LOS and in the rate of re-admission and a significant increase of the rate of direct home return after primary TKA compared with the national database. The significant increase in the re-operation rate warrants further investigation. However, FTP should become the standard of care after this intervention.
Entities:
Keywords:
Fast-track procedure; Total knee arthroplasty
Authors: Richard A Berger; Sheila A Sanders; Elizabeth S Thill; Scott M Sporer; Craig Della Valle Journal: Clin Orthop Relat Res Date: 2009-02-28 Impact factor: 4.176
Authors: Bas L Fransen; Marco J M Hoozemans; Kirsten D S Argelo; Lucien C M Keijser; Bart J Burger Journal: Arch Orthop Trauma Surg Date: 2018-07-19 Impact factor: 3.067