A review of clinical pathway data of 1,663 total knee arthroplasties in a tertiary institution in Singapore.
OBJECTIVE
A total knee arthroplasty (TKA) clinical pathway database has been used in our institution since the year 2000. The primary aim of this study was to review the patient epidemiology, postoperative complications and factors influencing hospital length of stay following TKA. The clinical outcomes and cost-savings between elective and same day admissions for TKA patients were also reviewed.


METHODS
The study cohort retrieved from the database comprised 1,371 patients (1,663 knees) who underwent total knee replacement over a 6-year time period. The following variables were reviewed: epidemiological data, admission data (elective admission [EA] versus same day admission [SDA]), hospital length of stay (LOS), and complication rates.


RESULTS
The mean age of patients undergoing TKA is 65.2 years (range, 22 to 90). Osteoarthritis was the main surgical indication in 96% of the study cohort. Overall, there was a gradual decline in the hospital length of stay for the study cohort for the 6-year time period. The overall complication rate was 2% and the 3 most common complications were deep vein thrombosis, pulmonary embolism and urinary tract infection.


CONCLUSIONS
With an increasing elderly population there will be an annual increase in the number of TKAs. In our local population TKAs are performed primarily for the Chinese female in the 7th decade. The overall complication rate of TKA remains low with a mortality rate of <1%.
Xu
G G
GG
Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.
Sathappan
S S
SS
Jaipaul
J
J
Chan
Siew Pang
SP
Lai
Choon Hin
CH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D017046:Cost Savings; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010343:Patient Admission / Q000191:economics / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D012846:Singapore / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D020246:Venous Thrombosis / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult