Clinical pathways in total knee arthroplasty: a New Zealand experience.
OBJECTIVE
To ascertain the effects of a clinical pathway in our institution.


METHODS
This retrospective and comparative study was performed on all patients undergoing total knee arthroplasty over a 5-year period. This period covered the 30 months prior to the introduction of the pathway (group 1), and the 30 months following its introduction (group 2).


RESULTS
There was a significant reduction in the duration of hospital stay of group 2 patients (p<0.0001), with 62.8% of these patients staying less than 8 postoperative days. There was a reduction in the number of patients with thromboembolic complications (p<0.05) and no increase in overall complications or readmission rate. There was a trend to increased use of rehabilitation services among group 2 patients.


CONCLUSIONS
Clinical pathway implementation resulted in a significant reduction in the length of stay, and achieved a more efficient management of hospitalised patients without compromising outcome.
Pennington
J M
JM
Department of Orthopaedic Surgery, Dunedin School of Medicine, Dunedin Hospital, Dunedin, New Zealand. david.gwynne-jones@stonebow.otago.ac.nz
Jones
D P G
DP
McIntyre
S
S
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D019091:Critical Pathways; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome