Department of Trauma and Orthopaedics, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
BMC Med. 2013 Feb 13;11:37. doi: 10.1186/1741-7015-11-37.
The increasing numbers of patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA), combined with the rapidly growing repertoire of surgical techniques and interventions available have put considerable pressure on surgeons and other healthcare professionals to produce excellent results with early functional recovery and short hospital stays. The current economic climate and the restricted healthcare budgets further necessitate brief hospitalization while minimizing costs.Clinical pathways and protocols introduced to achieve these goals include a variety of peri-operative interventions to fulfill patient expectations and achieve the desired outcomes.In this review, we present an evidence-based summary of common interventions available to achieve enhanced recovery, reduce hospital stay, and improve functional outcomes following THA and TKA. It covers pre-operative patient education and nutrition, pre-emptive analgesia, neuromuscular electrical stimulation, pulsed electromagnetic fields, peri-operative rehabilitation, modern wound dressings, standard surgical techniques, minimally invasive surgery, and fast-track arthroplasty units.
接受全髋关节置换术 (THA) 或全膝关节置换术 (TKA) 的患者数量不断增加，加上可供选择的手术技术和干预手段迅速增多，这使得外科医生和其他医疗保健专业人员面临着相当大的压力，他们需要通过早期功能恢复和缩短住院时间来取得优异的效果。当前的经济形势和有限的医疗预算进一步要求在尽量减少成本的同时缩短住院时间。为了实现这些目标而引入的临床路径和方案包括各种围手术期干预措施，以满足患者的期望并实现预期的结果。在本次综述中，我们基于证据对常见干预措施进行了总结，这些措施可用于促进康复、缩短住院时间并改善 THA 和 TKA 后的功能结果。内容涵盖术前患者教育和营养、预防性镇痛、神经肌肉电刺激、脉冲电磁场、围手术期康复、现代伤口敷料、标准手术技术、微创手术以及快速通道关节置换病房。
