The objectives are to describe the transition from traditional care to an enhanced recovery program for the management of total knee arthroplasty, and to evaluate the effect on patient outcomes.
Enhanced recovery programs are an organizational evolution in surgical patient management, in which the patient becomes an actor of his or her own recovery. This multimodal approach aims at optimizing patient physiological and psychological states across preoperative, intraoperative and postoperative domains of care. At la Rochelle hospital, the decision to take the step happened at the end of 2016. It was proposed by a young surgeon that have been trained on this new approach during his studies and who convinced the head of the surgery department of the benefits for the patients, the healthcare workers, and the institution. The transition took place in two stages, first operative and postoperative techniques were modified, and then preoperative education and counselling were added.
Study Type
OBSERVATIONAL
Enrollment
455
Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Groupe Hospitalier la Rochelle Ré Aunis
La Rochelle, France
Number of Patients With Early Complication
Recorded complications were Bleeding, Deep periprosthetic joint infection, Implant fracture, Instability, Patellofemoral dislocation, Readmission, Reoperation, Revision, Stiffness, Thromboembolic disease, Tibiofemoral dislocation, Vascular injury, Wound complication.
Time frame: 3 months after surgery
Number of Patients With Late Complication
Recorded complications were Bleeding, Deep periprosthetic joint infection, Implant fracture, Instability, Patellofemoral dislocation, Readmission, Reoperation, Revision, Stiffness, Thromboembolic disease, Tibiofemoral dislocation, Vascular injury, Wound complication.
Time frame: up to 28 months after surgery
Length of Hospital Stay
the time between admission for an operation and discharge from the hospital
Time frame: up to 1 month after surgery
Preoperative Knee Extension
Measure in degree of how much the knee straightens during consultation with surgeon
Time frame: up to 1 month before surgery
Postoperative Knee Extension
Measure in degree of how much the knee straightens during consultation with surgeon
Time frame: At 3 months after surgery
Preoperative Knee Flexion
Measure in degree of how much the knee bends during consultation with surgeon
Time frame: up to 1 month before surgery
Postoperative Knee Flexion
Measure in degree of how much the knee bends during consultation with surgeon
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Time frame: At 3 months after surgery