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Arthroplasty fast-track

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https://www.readbyqxmd.com/read/29306574/incidence-and-risk-factors-of-postoperative-urinary-retention-and-bladder-catheterization-in-patients-undergoing-fast-track-total-joint-arthroplasty-a-prospective-observational-study-on-371-patients
#1
Ruben Scholten, Keetie Kremers, Sebastiaan A W van de Groes, Diederik M Somford, Sander Koëter
BACKGROUND: Postoperative urinary retention (POUR) appears to be a common complication in lower limb joint arthroplasty; however, reports on its incidence vary. There is no general consensus on its definition and there is no scientific evidence on treatment principles. We performed a prospective observational study to establish the incidence of POUR and its risk factors, including the preoperative postvoid residual urine volume and the perioperative fluid balance, in fast-track total joint arthroplasty (TJA)...
December 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29260691/-fast-track-hip-arthroplasty
#2
Torben Bæk Hansen, Kirill Gromov, Billy B Kristensen, Henrik Husted, Henrik Kehlet
Fast-track surgery implies a coordinated perioperative approach aimed at reducing surgical stress and facilitating post-operative recovery. The fast-track programme has reduced post-operative length of stay and has led to shorter convalescence with more rapid functional recovery and decreased morbidity and mortality in total hip arthroplasty. It should now be a standard total hip arthroplasty patient pathway, but fine tuning of the multiple factors in the fast-track pathway is still needed in patients with special needs or high comorbidity burden...
December 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29208509/the-use-of-an-intraarticular-catheter-on-fast-track-primary-knee-arthroplasty-is-it-a-step-forward
#3
L Cáceres-Sánchez, J B García-Benítez, V Coronado-Hijón, M Montero-Pariente
OBJECTIVE: This study compares the efficacy in post-operative pain control of the intraarticular catheter compared to the epidural catheter after primary total knee arthroplasty. MATERIAL AND METHOD: Randomised clinical trial consisting of two groups of patients. A control group with intradural anaesthesia and an intraoperative epidural catheter (ropivacaine) and an intervention group using the same anaesthetic technique and an intraarticular catheter with an elastomeric pump (ropivacaine+dexketoprofen)...
December 2, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29204497/decreased-risk-of-knee-buckling-with-adductor-canal-block-versus-femoral-nerve-block-in-total-knee-arthroplasty-a-retrospective-cohort-study
#4
Ryan R Thacher, Thomas R Hickernell, Matthew J Grosso, Roshan Shah, Herbert J Cooper, Robert Maniker, Anthony Robin Brown, Jeffrey Geller
Background: Femoral nerve (FNB) and adductor canal blocks (ACB) are used in the setting of total knee arthroplasty (TKA), but neither has been demonstrated to be clearly superior. Although dynamometer studies have shown ACBs spare perioperative quadriceps function when compared to FNBs, ACBs have been widely adopted in orthopaedic surgery without significant evidence that they decrease the risk of perioperative falls. Methods: All patients who received single-shot FNB (129 patients) or ACB (150 patients) at our institution for unilateral primary TKA from April 2014 to September 2015 were retrospectively reviewed for perioperative falls or near-falls during physical therapy and inpatient care...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29202644/outpatient-total-hip-and-knee-arthroplasty
#5
Stephan B W Vehmeijer, Henrik Husted, Henrik Kehlet
As a result of the introduction of fast-track programs, the length of hospital stay after arthroplasty has decreased to a point where some patients meet the discharge criteria on the day of surgery. In several studies, well-established fast-track centers have demonstrated the feasibility of outpatient procedures in selected patients. However, in literature the term "outpatient" is sometimes also used for patients who spend one or more nights in hospital. We therefore propose to use "outpatient" solely for patients who are discharged to their own home on the day of surgery and do not have an overnight stay at either the hospital or another non-home facility...
December 5, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29198872/a-randomized-non-inferiority-trial-of-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty-single-injection-versus-catheter-technique
#6
Steven Lee, Nirooshan Rooban, Himat Vaghadia, Andrew N Sawka, Raymond Tang
BACKGROUND: Adductor canal blocks (ACBs) provide effective analgesia following total knee arthroplasty. We hypothesized that ACB single injection plus intravenous (IV) dexamethasone (Dex) shows non-inferiority to catheter, while ACB single injection does not. METHODS: One hundred eighty patients were randomized and 177 analyzed from among 1 of 3 ACB interventions: (1) 0.5% ropivacaine 20 mL; (2) 0.5% ropivacaine 20 mL plus IV Dex 8 mg; (3) 0.5% ropivacaine 20 mL followed by continuous infusion of 0...
November 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29160123/fast-tracking-for-total-knee-replacement-reduces-use-of-institutional-care-without-compromising-quality
#7
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR. Patients and methods - 4,256 TKRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D)...
November 21, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29102512/ninety-day-morbidity-and-mortality-in-risk-screened-and-optimized-patients-undergoing-two-team-fast-track-simultaneous-bilateral-tka-compared-with-unilateral-tka-a-prospective-study
#8
Vikas Kulshrestha, Santhosh Kumar, Barun Datta, V K Sinha, Gaurav Mittal
BACKGROUND: Simultaneous bilateral total knee arthroplasty (SBTKA) offers significant socioeconomic benefits. However, retrospective studies and public health data show increased mortality and morbidity rates in patients undergoing SBTKA compared with those undergoing unilateral TKA (UTKA), and there have been recommendations against the use of SBTKA. High-volume centers, which feature careful patient selection and fast-tracked surgery, continue to perform SBTKA and have published their results in favor of the procedure...
October 10, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29022751/prospective-psychometric-characterization-of-hip-and-knee-arthroplasty-patients
#9
Silas Hinsch Gylvin, Anders Fink-Jensen, Henrik Kehlet, Christoffer Calov Jørgensen, Mogens Berg Laursen, Kirill Gromov, Henrik Morville Schroder, Susanne Jung Høvsgaard, Heidi Raahauge Wede, Phillip Raphael Kyle, Per Bech
BACKGROUND: Psychiatric conditions and psychopharmacological treatments have been demonstrated to be important risk-factors for prolonged hospital length of stay, readmission and morbidity, following fast-track total hip (THA) and total knee arthroplasty (TKA). AIMS: The aim of the study was to provide a detailed description of the preoperative psychiatric characteristics of a well-defined patient population undergoing THA and TKA, using the 90-item Symptom Checklist (SCL-90-R)...
October 12, 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28985252/age-and-sex-based-recovery-curves-to-track-functional-outcomes-in-older-adults-with-total-knee-arthroplasty
#10
Yong-Hao Pua, Felicia Jie-Ting Seah, Cheryl Lian-Li Poon, John Wei-Ming Tan, Ross Alan Clark, Jennifer Suet-Ching Liaw, Hwei-Chi Chong
Background: older adults with total knee arthroplasty (TKA) frequently undergo rehabilitation to address limited knee flexion range-of-motion, quadriceps weakness and gait speed limitations. This study aimed to develop age- and sex-specific recovery curves of knee flexion range-of-motion, quadriceps strength and fast gait speed post-TKA. Methods: a population-based sample of 2,987 patients undergoing primary TKA participated, of whom 2015 (68%) were 65 years of age or older...
August 30, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28933332/the-impact-of-caregivers-anxiety-on-patients-anxiety-before-fast-track-knee-arthroplasty
#11
P Zietek, B Zarzycka, J Zietek, M Stepien-Slodkowska, E Sienko-Awierianow, D Kotrych, K Dobiecki
PURPOSE OF THE STUDY Anxiety may have negative repercussions on the surgery including poorer outcomes. On the other hand, the majority of patients reporting preoperative anxiety fear not receiving enough attention from a caregiver. In patients undergoing fast-track knee arthroplasty, we determined the relationship between patients' preoperative anxiety and the anxiety the patient's caregiver. We also analyzed the influence of selected psychosocial and demographic variables on the relationship between caregivers' and patients' anxiety...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28918788/-fast-track-total-knee-arthroplasty
#12
Kirill Gromov, Billy B Kristensen, Christoffer Calov Jørgensen, Torben Bæk Hansen, Henrik Kehlet, Henrik Husted
Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery, thus leading to lower mortality and morbidity as well as high patient satisfaction. All patients are eligible for fast-track TKA, and hence the fast-track concept should be standard at all joint replacement facilities. Future challenges of fast-track TKA include safe introduction of outpatient protocols, acute and chronic pain after surgery and optimal utilization of post-operative physiotherapy...
September 18, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28914103/the-first-6-weeks-of-recovery-after-primary-total-hip-arthroplasty-with-fast-track
#13
Lisette C M Klapwijk, Nina M C Mathijssen, Jeroen C van Egmond, Bianca M Verbeek, Stephan B W Vehmeijer
No abstract text is available yet for this article.
September 15, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28900757/low-incidence-of-postoperative-urinary-retention-with-the-use-of-a-nurse-led-bladder-scan-protocol-after-hip-and-knee-arthroplasty-a-retrospective-cohort-study
#14
N P Kort, Y Bemelmans, R Vos, M G M Schotanus
PURPOSE: Postoperative urinary retention (POUR), defined as the inability to empty the bladder voluntary after surgery, is a commonly reported complication. This study reports the incidence and possible risk factors for POUR after elective fast-track hip or knee arthroplasty when using a nurse-led bladder scan protocol. METHODS: This retrospective cohort study included data from 803 patients who underwent unilateral hip or knee arthroplasty. Patients' digital clinical records were reviewed for eligibility...
September 12, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28880108/reduced-length-of-uninterrupted-institutional-stay-after-implementing-a-fast-track-protocol-for-primary-total-hip-replacement
#15
Konsta J Pamilo, Paulus Torkki, Mikko Peltola, Maija Pesola, Ville Remes, Juha Paloneva
Background and purpose - Fast-track protocols have been successfully implemented in many hospitals as they have been shown to result in shorter length of stay (LOS) without compromising results. We evaluated the effect of fast-track implementation on the use of institutional care and results after total hip replacement (THR). Patients and methods - 3,193 THRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register...
September 7, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28854533/safety-aspects-of-preoperative-high-dose-glucocorticoid-in-primary-total-knee-replacement
#16
C C Jørgensen, F T Pitter, H Kehlet
Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation Database for Fast-track Hip and Knee Replacement introduced preoperative methylprednisolone (MP) 125 mg as part of a multimodal analgesic protocol in TKA. We analysed the risk of length of hospital stay (LOS) >4 days, 30 and 90 day readmissions in patients with MP vs patients having TKA before the use of MP and adjusted for comorbidity and place of surgery...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28836971/which-patient-specific-and-surgical-characteristics-influence-postoperative-pain-after-tha-in-a-fast-track-setting
#17
Yvon M den Hartog, Gerjon Hannink, Nick T van Dasselaar, Nina M Mathijssen, Stephan B Vehmeijer
BACKGROUND: In our hospital a fast-track setting including a multimodal pain protocol is used for total hip arthroplasty (THA). Despite this multimodal pain protocol there is still a large range in reported postoperative pain between patients, which hinders mobilization and rehabilitation postoperatively. The goal of this study was to identify which patient-specific and surgical characteristics influence postoperative pain after THA in a fast-track setting. METHODS: All 74 patients with osteoarthritis of the hip who underwent primary THA procedure by anterior supine intermuscular approach between November 2012 and January 2014 were included in this prospective cohort study...
August 24, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28833302/patient-experience-with-early-discharge-after-total-knee-arthroplasty-a-focus-group-study
#18
Lise Husby Høvik, Bjørg Aglen, Vigdis Schnell Husby
BACKGROUND: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast-track pathway aims at improving patient outcome, and patients are now discharged 2-3 days after surgery. Little is known about how the patients cope with pain, exercise or daily activities at home. AIM: To explore the experience of patients undergoing total knee arthroplasty in a fast-track pathway during the first 2 weeks after surgery...
August 23, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28831572/fast-track-and-outpatient-surgery-in-total-knee-arthroplasty-beneficial-for-patients-doctors-and-hospitals
#19
EDITORIAL
Michael T Hirschmann, Nanne Kort, Sebastian Kopf, Roland Becker
No abstract text is available yet for this article.
September 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28801413/effectiveness-of-rehabilitation-after-a-total-hip-arthroplasty-a-protocol-for-an-observational-study-for-the-comparison-of-usual-care-in-the-netherlands-versus-germany
#20
Gesine H Seeber, Annet Wijnen, Djordje Lazovic, Sjoerd K Bulstra, Günter Dietz, Christiaan P van Lingen, Martin Stevens
INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare...
August 11, 2017: BMJ Open
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