Van Egmond Jeroen C, Verburg Hennie, Mathijssen Nina M C
a Department of Orthopedic Surgery , Reinier de Graaf Groep , Delft , the Netherlands .
Acta Orthop. 2015;86(6):708-13. doi: 10.3109/17453674.2015.1081356. Epub 2015 Oct 9.
During the last decade, many hospitals have implemented fast-track protocols for total knee arthroplasty (TKA). These protocols reduce the length of hospital stay, but there is no literature on the first period after hospital discharge. We determined how patients experienced the first 6 weeks after hospital discharge after fast-track TKA surgery.
34 consecutive patients who had TKA surgery with fast track received a diary for 6 weeks, which contained various international validated questionnaires. In addition, general questions regarding pain, the wound, physiotherapy, and thrombosis prophylaxis injections were posed.
4 of the 34 patients were excluded during the study. Of the remaining 30 patients, 28 were positive regarding the short length of hospital stay. Pain gradually decreased and quality of life and function gradually improved during the 6 weeks. Mean hours of weekly physiotherapy were 0.6 for the first week and 0.9 during the sixth week, with high variance of treatment modalities due to the lack of standardized treatment protocols. Additional clinical consultations were needed in 9 patients during the 6-week period.
28 of 30 patients were satisfied with the short length of hospital stay. The intensity of physiotherapy was surprisingly low. The quality of life 6 weeks after discharge was similar to that before the surgery.
在过去十年间，许多医院已实施全膝关节置换术（TKA）的快速康复方案。这些方案缩短了住院时间，但关于出院后首个阶段的文献尚属空白。我们确定了患者在接受快速康复TKA手术后出院后头6周的体验。
34例接受快速康复TKA手术的连续患者收到一份为期6周的日记，其中包含各种经过国际验证的问卷。此外，还提出了关于疼痛、伤口、物理治疗和预防血栓注射的一般性问题。
研究期间34例患者中有4例被排除。其余30例患者中，28例对住院时间短表示满意。在这6周内，疼痛逐渐减轻，生活质量和功能逐渐改善。第一周每周平均物理治疗时长为0.6小时，第六周为0.9小时，由于缺乏标准化治疗方案，治疗方式差异很大。6周内有9例患者需要额外的临床会诊。
30例患者中有28例对住院时间短感到满意。物理治疗强度出奇地低。出院6周后的生活质量与手术前相似。
