Department of Trauma and Orthopaedic Surgery, Princess Royal University Hospital, King's College NHS Foundation Trust, Farnborough Common, Orpington, UK.
Department of Trauma and Orthopaedic Surgery, Princess Royal University Hospital, King's College NHS Foundation Trust, Farnborough Common, Orpington, UK.
Knee. 2021 Dec;33:378-385. doi: 10.1016/j.knee.2021.10.022. Epub 2021 Nov 12.
Day case unicompartmental knee arthroplasty (UKA) is increasingly being performed worldwide. When performed in the appropriate patient, day case UKA has been demonstrated to be safe, cost effective and improve resource allocation. Limited evidence highlights increased patient satisfaction of day case UKA when compared with inpatient UKA. A detailed study of the patient perspective, experience and satisfaction following day case UKA has not been described before.
A retrospective case series review of 21 consecutive patients (19 unilateral, 2 bilateral) undergoing day case UKA in an elective orthopaedic centre was undertaken. A qualitative and quantitative patient assessment of the day case UKA experience was administered. A five-point Likert scale satisfaction questionnaire, Oxford Knee Score (OKS) and open-ended interview was undertaken. The qualitative responses underwent thematic analysis.
One hundred percent of patients expressed satisfaction (76.2% completely satisfied, 33.8% moderately satisfied) with day case UKA. The majority of patients (90.5%) reported that if they had to undergo UKA again they would prefer a day case over an inpatient procedure. Patients consider surgical outcome, physiotherapy provision, discharge planning, postoperative medications and follow up as key aspects of day case UKA care. One patient was re-admitted following discharge.
The present study demonstrates a high level of patient satisfaction with day case UKA. The results reported herein are subject to the study limitations of sample size, recall bias and inclusion criteria. We recommend that the themes identified by patients are addressed through a multidisciplinary approach with well-defined clinical pathways for a high-quality patient-centred experience.
日间单髁膝关节置换术(UKA)在全球范围内的应用日益增多。在合适的患者中进行日间 UKA 已被证明是安全、具有成本效益的,并能改善资源配置。有限的证据表明,与住院 UKA 相比,日间 UKA 能提高患者满意度。以前没有详细描述过日间 UKA 后患者的观点、体验和满意度。
对在一家择期骨科中心接受日间 UKA 的 21 例连续患者(19 例单侧,2 例双侧)进行回顾性病例系列研究。对日间 UKA 体验进行了定性和定量的患者评估。采用 5 分 Likert 量表满意度问卷、牛津膝关节评分(OKS)和开放式访谈进行评估。对定性反应进行主题分析。
100%的患者对日间 UKA 表示满意(76.2%完全满意,33.8%满意)。大多数患者(90.5%)表示,如果他们再次需要进行 UKA,他们更愿意选择日间手术而非住院手术。患者认为手术结果、物理治疗提供、出院计划、术后药物和随访是日间 UKA 护理的关键方面。有 1 例患者在出院后再次入院。
本研究表明,患者对日间 UKA 的满意度很高。本研究结果受到样本量、回忆偏倚和纳入标准的研究局限性的影响。我们建议通过多学科方法解决患者提出的主题,并制定明确的临床路径,以提供高质量的以患者为中心的体验。