Renkawitz, Tobias and Rieder, T. and Handel, M. and Koller, M. and Drescher, J. and Bonnlaender, G. and Grifka, J. (2010) Comparison of two accelerated clinical pathways - after total knee replacement how fast can we really go? CLINICAL REHABILITATION, 24 (3). pp. 230-239. ISSN 0269-2155,
Full text not available from this repository. (Request a copy)Abstract
Objective: To evaluate whether a further optimization of an existing accelerated clinical pathway protocol after total knee replacement is feasible and improves postoperative outcome. Design: Prospective, parallel group design. Setting: Orthopaedic University Medical Centre. Patients: A total of 143 patients, scheduled for unilateral primary total knee replacement under perioperative regional analgesia. Intervention: Sixty-seven patients received an optimized accelerated clinical pathway including patient-controlled regional analgesia pumps, ultra-early/doubled physiotherapy and motor-driven continuous passive motion machine units. Seventy-six patients received a standard accelerated clinical pathway. Main measures: Feasibility was defined as the proportion of patients successfully completing the assigned pathway. Early postoperative pain on a visual analogue scale, consumption of regional anaesthetics, knee range of motion, time out of bed, non-stop walking distance/stair climbing, circumference measurement and Knee Society Score on the operated leg. Possible discharge according to an own discharge checklist. Results: All patients assigned to both groups successfully completed this pathway. Patients in the optimized pathway showed significant benefits regarding stair climbing/walking distance/time out of bed/circumference measurements of the thigh/Knee Society function score on the fifth postoperative day and stair climbing/ circumference measurements of the thigh on the eighth postoperative day, and reduction of the consumption of regional anaesthetics. No significant reduction in length of stay was observed. Conclusions: Early postoperative functional process indicators tended to be higher within the optimized pathway group, but the main effects flattened over the course of the first eight postoperative days.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RANDOMIZED CONTROLLED-TRIAL; TOTAL HIP; ARTHROPLASTY; REHABILITATION; MANAGEMENT; SURGERY; EFFICACY; LENGTH; STAY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 05 Aug 2020 04:57 |
| Last Modified: | 05 Aug 2020 04:57 |
| URI: | https://pred.uni-regensburg.de/id/eprint/25021 |
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