Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients.
TLDR
Age, sex, marital status, co-morbidity, preoperative use of walking aids, pre- and postoperative hemoglobin levels, the need for blood transfusion, ASA score, and time between surgery and mobilization, were all found to influence postoperative outcome in general and LOS in particular.Abstract:
Background and purpose Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospe...read more
Citations
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Journal ArticleDOI
Why still in hospital after fast-track hip and knee arthroplasty?
Henrik Husted,Troels Haxholdt Lunn,Anders Troelsen,L. Gaarn-Larsen,B. B. Kristensen,Henrik Kehlet +5 more
TL;DR: Pain, dizziness, and general weakness were the main clinical reasons for being hospitalized at 24 and 48 hours postoperatively while nausea, vomiting, confusion, and sedation delayed discharge to a minimal extent.
Journal ArticleDOI
Enhanced recovery program for hip and knee replacement reduces death rate
TL;DR: This large observational study of 4,500 consecutive unselected consecutive hip and knee arthroplasty patients shows a substantial reduction in death rate, reduced length of stay, and reduced transfusion requirements after the introduction of a multimodal enhanced recovery protocol.
Journal ArticleDOI
Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial
Troels Haxholdt Lunn,B. B. Kristensen,L. Ø. Andersen,Henrik Husted,Kristian S Otte,L. Gaarn-Larsen,Henrik Kehlet,Henrik Kehlet +7 more
TL;DR: MP 125 mg before surgery improves analgesia and immediate recovery after TKA, even when combined with a multimodal analgesic regime, and these findings call for further studies on safety aspects.
Journal ArticleDOI
Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study.
TL;DR: This study demonstrates that appropriately selected patients can undergo total hip arthroplasty in an outpatient setting with no increase in complications and at a substantial savings to the healthcare system.
Journal ArticleDOI
Effect of a patient blood management programme on preoperative anaemia, transfusion rate, and outcome after primary hip or knee arthroplasty: a quality improvement cycle.
TL;DR: A systematic approach to optimize Hb mass before arthroplasty and limit Hb loss perioperatively was associated with improved outcome up to 90 days after discharge, and it is concluded that preoperative Hb predicts markers of arthro Plasty outcome in UK practice.
References
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Journal ArticleDOI
Multimodal strategies to improve surgical outcome.
Henrik Kehlet,Douglas W. Wilmore +1 more
TL;DR: Understanding perioperative pathophysiology and implementation of care regimes to reduce the stress of an operation, will continue to accelerate rehabilitation associated with decreased hospitalization and increased satisfaction and safety after discharge.
Journal ArticleDOI
Rates and outcomes of primary and revision total hip replacement in the United States medicare population.
Nizar N. Mahomed,Jane Barrett,Jeffrey N. Katz,Charlotte B. Phillips,Elena Losina,Robert A. Lew,Edward Guadagnoli,William H. Harris,Robert Poss,John A. Baron +9 more
TL;DR: Analysis of United States Medicare population data showed that the rates of total hip replacement increased with age up to the age of seventy-five to seventy-nine years and that blacks had a significantly lower rate of total hips replacement than whites.
Journal ArticleDOI
Preoperative education for hip or knee replacement
TL;DR: Whether preoperative education in people undergoing total hip replacement or total knee replacement improves postoperative outcomes with respect to pain, function, health-related quality of life, anxiety, length of hospital stay and the incidence of adverse events is investigated.
Journal ArticleDOI
Clinical pathways in hip and knee arthroplasty: a prospective randomised controlled study.
TL;DR: To ascertain the effectiveness of clinical pathways for improving patient outcomes and decreasing lengths of stay after hip and knee arthroplasty, a large number of patients are referred to the Hospital for Elite Surgical Excellence (HSE) in London.
Journal ArticleDOI
Impact Of Cost Reduction Programs On Short-term Patient Outcome And Hospital Cost Of Total Knee Arthroplasty
TL;DR: The clinical pathway and the knee-implant standardization program reduced resource utilization and hospital cost for total knee arthroplasty without affecting short-term patient outcome in the authors' hospital.
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Evidence-based surgical care and the evolution of fast-track surgery.
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