To investigate the impact of consecutive perioperative care transitions on in-hospital recovery of patients who had primary total knee arthroplasty (TKA) over an 11-year period. This observational cohort study used electronic health record data from all patients undergoing preoperative screening for primary TKA at a Northern Netherlands hospital between 2009 and 2020. In this timeframe, three perioperative care transitions were divided into four periods: Baseline care (Joint Care, n = 171; May 2009 to August 2010), Function-tailored (n = 404; September 2010 to October 2013), Fast-track (n = 721; November 2013 to May 2018), and Prehabilitation (n = 601; June 2018 to December 2020). In-hospital recovery was measured using inpatient recovery of activities (IROA), length of stay (LOS), and discharge to preoperative living situation (PLS). Multivariable regression models were used to analyze the impact of each perioperative care transition on in-hospital recovery.Aims
Methods
There is a large amount of evidence available
about the relative merits of unicompartmental and total knee arthroplasty
(UKA and TKA). Based on the same evidence, different people draw
different conclusions and as a result, there is great variability
in the usage of UKA. The revision rate of UKA is much higher than TKA and so some
surgeons conclude that UKA should not be performed. Other surgeons
believe that the main reason for the high revision rate is that
UKA is easy to revise and, therefore, the threshold for revision
is low. They also believe that UKA has many advantages over TKA
such as a faster recovery, lower morbidity and mortality and better
function. They therefore conclude that UKA should be undertaken
whenever appropriate. The solution to this argument is to minimise the revision rate
of UKA, thereby addressing the main disadvantage of UKA. The evidence
suggests that this will be achieved if surgeons use UKA for at least
20% of their knee arthroplasties and use implants that are appropriate
for these broad indications. Cite this article:
