Elective Surgery Centre, Silkeborg Regional Hospital; University Research Clinic for Innovative Patient Pathways, Diagnostic Centre, Silkeborg Regional Hospital.
Elective Surgery Centre, Silkeborg Regional Hospital.
Acta Orthop. 2022 Jun 1;93:509-518. doi: 10.2340/17453674.2022.2807.
Despite increased attention to and acceptance of fast-track procedures, there is a lack of studies concerning discharge on the day of surgery (DOS) following total knee arthroplasty (SD-TKA). We evaluated the feasibility of SD-TKA, and compared safety and patient-reported outcomes (PROs) between patients undergoing SD-TKA and patients undergoing standard TKA.
A SD-TKA group (n = 101) was matched 1:1 to a standard TKA group (n = 101) on age, sex, and ASA score. Feasibility (being discharged on DOS), safety (unplanned contacts and complications evaluated by telephone calls (2 weeks), outpatient visits (2 weeks), and readmission (90 days)) were assessed. Further, Oxford Knee Score (OKS) and Visual Analogue Scale (VAS) (pain at rest and activity) were reported (90 days).
89 of 101 SD-TKA patients were discharged on DOS. The number of telephone calls (≤ 83) and outpatient visits (12) were similar in the 2 groups. The number of readmissions was ≤ 3 in both groups, and only 1 of the readmissions was related to TKA surgery. No differences were found at 90-day follow-up in terms of OKS (34 in both groups) or VAS (rest: SD-TKA = 7 and standard TKA = 8; activity: SD-TKA = 17 and standard TKA = 15).
SD-TKA is feasible in a selected group of patients, and safety and PROs are comparable to patients undergoing standard TKA.
尽管快速通道程序越来越受到关注和接受，但关于全膝关节置换术（SD-TKA）后当天出院（DOS）的研究仍然缺乏。我们评估了 SD-TKA 的可行性，并比较了接受 SD-TKA 和标准 TKA 的患者的安全性和患者报告的结果（PROs）。
SD-TKA 组（n = 101）与标准 TKA 组（n = 101）在年龄、性别和 ASA 评分上进行 1:1 匹配。评估可行性（是否在 DOS 当天出院）、安全性（通过电话（2 周）、门诊就诊（2 周）和再次入院（90 天）评估非计划性接触和并发症）。此外，报告了牛津膝关节评分（OKS）和视觉模拟量表（VAS）（休息和活动时的疼痛）（90 天）。
101 例 SD-TKA 患者中有 89 例在 DOS 当天出院。两组的电话次数（≤83 次）和门诊就诊次数（12 次）相似。两组的再入院次数均≤3 次，且仅有 1 例再入院与 TKA 手术有关。在 90 天随访时，两组的 OKS（均为 34）或 VAS（休息：SD-TKA = 7，标准 TKA = 8；活动：SD-TKA = 17，标准 TKA = 15）均无差异。
在选定的患者群体中，SD-TKA 是可行的，安全性和 PROs 与接受标准 TKA 的患者相当。
