Moulton Lawrence Stephen, Evans Peter A, Starks Ian, Smith Tony
Department of Orthopaedics, Wrexham Maelor Hospital, Wrexham, UK.
Musculoskeletal Care. 2017 Dec;15(4):341-344. doi: 10.1002/msc.1177. Epub 2017 Jan 4.
Enhanced recovery programmes have improved outcomes following elective arthroplasty surgery. There are few studies assessing the role of patient education. In our enhanced recovery programme, all patients are offered the chance to attend a preoperative education class. Not all patients attend, enabling a comparison of outcomes. We have published data demonstrating that patients undergoing hip arthroplasty have improved outcomes. In the present article, we present data for total knee arthroplasty. Using a prospectively collected database, we identified all patients undergoing elective primary total knee arthroplasty. Data were assessed to look at patient outcomes. This was analysed using non-parametric tests. Between April 2009 and March 2013, 563 patients underwent elective total knee replacement. A total of 503 attended the class and 60 did not. Patients attending had a reduced length of stay when compared with the non-attenders but this did not reach statistical significance (4.13 days versus 4.57 days; p = 0.118). The spread of length of stay was slightly larger in the group that attended. Our analysis demonstrated that, for these patients, there is no statistically significant difference in length of stay or outcome scores. Therefore, in tougher economic times it may be prudent to focus preoperative education on total hip arthroplasty patients if resources are limited.
强化康复计划改善了择期关节置换手术后的治疗效果。评估患者教育作用的研究较少。在我们的强化康复计划中，所有患者都有机会参加术前教育课程。并非所有患者都参加，这使得我们能够对结果进行比较。我们已发表的数据表明，接受髋关节置换术的患者治疗效果有所改善。在本文中，我们展示了全膝关节置换术的数据。利用前瞻性收集的数据库，我们确定了所有接受择期初次全膝关节置换术的患者。对数据进行评估以观察患者的治疗效果。使用非参数检验进行分析。在2009年4月至2013年3月期间，563例患者接受了择期全膝关节置换术。其中503例参加了课程，60例未参加。与未参加课程的患者相比，参加课程的患者住院时间缩短，但未达到统计学显著性差异（4.13天对4.57天；p = 0.118）。参加课程的组住院时间的离散度略大。我们的分析表明，对于这些患者，住院时间或治疗效果评分没有统计学显著性差异。因此，在经济形势较为严峻的时期，如果资源有限，将术前教育重点放在全髋关节置换术患者身上可能是明智的。
