Accelerated recovery for unicompartmental knee replacement--a feasibility study.
A pilot study assessed the feasibility of discharging NHS patients undergoing knee replacement within a day of surgery. Seven patients with medial compartment osteoarthritis were recruited after fulfilling strict exclusion criteria. Pre-operative assessment revealed that all patients had significant dysfunction and pain before operation. They had medial unicompartmental replacement through a short incision without dislocation of the patella. Each patient underwent an accelerated recovery program that included pain control, physiotherapy and self-assessment. Patients were mobilised immediately after operation. Follow-up assessment was performed at 1, 2 and 6 weeks after surgery. All patients, except one (who failed to go home because of an administrative error), returned home the day after surgery. The average pain score for the first 2 weeks after surgery was 2/10. At 6 weeks, knee flexion averaged 125 degrees and all patients were walking independently and painfree. The new protocol allows for early, safe discharge of patients undergoing unicompartmental knee replacement.
Beard
D J
DJ
Nuffield Department of Orthopaedic Surgery, NDOS, University of Oxford, The Nuffield Orthopaedic Centre NHS Trust, Headington, Oxford OX3 7LD, UK. david.beard@ndos.ox.ac.uk
Murray
D W
DW
Rees
J L
JL
Price
A J
AJ
Dodd
C A F
CA
D000368:Aged; D000556:Ambulatory Surgical Procedures; D019645:Arthroplasty, Replacement, Knee; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008592:Menisci, Tibial / Q000503:physiopathology* / Q000601:surgery*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D010147:Pain Measurement; D010351:Patient Discharge; D010865:Pilot Projects; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors