Academic Journal
Comparison of two accelerated clinical pathways - after total knee replacement how fast can we really go?
| العنوان: | Comparison of two accelerated clinical pathways - after total knee replacement how fast can we really go? |
|---|---|
| المؤلفون: | Renkawitz, T., Rieder, T., Handel, M., Koller, M., Drescher, J., Bonnlaender, G., Grifka, J. |
| المصدر: | Clinical Rehabilitation ; volume 24, issue 3, page 230-239 ; ISSN 0269-2155 1477-0873 |
| بيانات النشر: | SAGE Publications |
| سنة النشر: | 2010 |
| الوصف: | Objective: To evaluate whether a further optimization of an existing accelerated clinical pathway protocol after total knee replacement is feasible and improves postoperative outcome. Design: Prospective, parallel group design. Setting: Orthopaedic University Medical Centre. Patients: A total of 143 patients, scheduled for unilateral primary total knee replacement under perioperative regional analgesia. Intervention: Sixty-seven patients received an optimized accelerated clinical pathway including patient-controlled regional analgesia pumps, ultra-early/doubled physiotherapy and motor-driven continuous passive motion machine units. Seventy-six patients received a standard accelerated clinical pathway. Main measures: Feasibility was defined as the proportion of patients successfully completing the assigned pathway. Early postoperative pain on a visual analogue scale, consumption of regional anaesthetics, knee range of motion, time out of bed, non-stop walking distance/stair climbing, circumference measurement and Knee Society Score on the operated leg. Possible discharge according to an own discharge checklist. Results: All patients assigned to both groups successfully completed this pathway. Patients in the optimized pathway showed significant benefits regarding stair climbing/walking distance/time out of bed/circumference measurements of the thigh/Knee Society function score on the fifth postoperative day and stair climbing/ circumference measurements of the thigh on the eighth postoperative day, and reduction of the consumption of regional anaesthetics. No significant reduction in length of stay was observed. Conclusions: Early postoperative functional process indicators tended to be higher within the optimized pathway group, but the main effects flattened over the course of the first eight postoperative days. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.1177/0269215509353267 |
| الاتاحة: | http://dx.doi.org/10.1177/0269215509353267 http://journals.sagepub.com/doi/pdf/10.1177/0269215509353267 |
| Rights: | http://journals.sagepub.com/page/policies/text-and-data-mining-license |
| رقم الانضمام: | edsbas.98A94E61 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1177/0269215509353267 |
|---|