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.
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
D J
DJ
Beard
D W
DW
Murray
J L
JL
Rees
A J
AJ
Price
C A F
CA
Dodd
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