Early Mobilization and Functional Discharge Criteria Affecting Length of Stay after Total Elbow Arthroplasty

被引:0
作者
Prkic, A. [1 ]
Viveen, J. [1 ]
The, B. [1 ]
Koenraadt, K. L. M. [2 ]
Eygendaal, D. [1 ,3 ]
机构
[1] Amphia Hosp, Dept Orthoped Surg, Breda, Netherlands
[2] Amphia Hosp, Fdn Orthoped Res Care & Educ, Breda, Netherlands
[3] Univ Amsterdam, Dept Orthoped Surg, Amsterdam, Netherlands
关键词
fast track rehabilitation; cast; total elbow arthroplasty; length of stay; discharge; complications; FAST-TRACK HIP; PATIENT SATISFACTION; KNEE ARTHROPLASTY; OUTCOMES; COMPLICATIONS; EXPERIENCE;
D O I
暂无
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
PURPOSE OF THE STUDY Decline in length of stay is of growing interest for patients, doctors and health insurances. The aim of our study was to assess the safety and length of stay after omission of casting, start of early mobilization and implementation of functional discharge criteria after total elbow arthroplasty (TEA). MATERIAL AND METHODS We retrospectively reviewed all patients' records who received a Coonrad-Morrey TEA in the period from January 1st, 2011 to December 31st, 2018. From these records, indications, demographic information and complications were derived. Length of stay was calculated from the hospital administration. Patients were divided in three groups to evaluate the two changes in post-operative care. RESULTS In total 125 patients receiving 126 Coonrad-Morrey TEAs were included with a mean length of stay of 5.5 days (range 2-23) for the entire group. Omitting a post-operative cast led to decline in length of stay from 6.2 to 5.4 days (p < 0.001). Introduction of functional discharge criteria in August 2017 declined mean length of stay to 3.8 days (p < 0.001). The surgical technique (triceps-on versus triceps-off) was not a confounder (p = 0.20). Range of motion after one year was not significantly different between groups. DISCUSSION The length of stay declined after omission of a cast, and declined further after introducing functional discharge criteria. Since no higher complication rates were observed, the shortening of length of stay appears to be safe. This is in line with other fast-track programs, i.e. for hip and knee arthroplasty. The surgical technique used were not a confounder for the shortened length of stay, which further adds to the safety of the functional discharge criteria. CONCLUSIONS Omitting a cast and splint as regular post-operative treatment reduced the length of stay significantly without leading to more complications. Introduction of functional discharge criteria lowered the length of stay further without more complications.
引用
收藏
页码:197 / 202
页数:6
相关论文
共 15 条
[1]  
Albert Ben M, 2017, J Surg Orthop Adv, V26, P25
[2]   Physiotherapy Exercise After Fast-Track Total Hip and Knee Arthroplasty: Time for Reconsideration? [J].
Bandholm, Thomas ;
Kehlet, Henrik .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2012, 93 (07) :1292-1294
[3]  
Booker Simon J, 2017, Shoulder Elbow, V9, P105, DOI 10.1177/1758573216682479
[4]   Predictors of length of stay and patient satisfaction after hip and knee replacement surgery - Fast-track experience in 712 patients [J].
Husted, Henrik ;
Holm, Gitte ;
Jacobsen, Steffen .
ACTA ORTHOPAEDICA, 2008, 79 (02) :168-173
[5]   Total elbow arthroplasty as an outpatient procedure using a continuous infraclavicular nerve block at home: A prospective case report [J].
Ilfeld, BM ;
Wright, TW ;
Enneking, FK ;
Vandenborne, K .
REGIONAL ANESTHESIA AND PAIN MEDICINE, 2006, 31 (02) :172-176
[6]   Outcomes in smokers and alcohol users after fast-track hip and knee arthroplasty [J].
Jorgensen, C. C. ;
Kehlet, H. .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2013, 57 (05) :631-638
[7]   Feasibility of day-case total hip arthroplasty: a single-centre observational study [J].
Larsen, Jens Rolighed ;
Skovgaard, Birgitte ;
Pryno, Thomas ;
Bendikas, Laimonas ;
Mikkelsen, Lone R. ;
Laursen, Malene ;
Hoybye, Mette T. ;
Mikkelsen, Soren ;
Jorgensen, Lene Bastrup .
HIP INTERNATIONAL, 2017, 27 (01) :60-65
[8]   Outcomes, complications, utilization trends, and risk factors for primary and revision total elbow replacement [J].
Lovy, Andrew J. ;
Keswani, Aakash ;
Dowdell, James ;
Koehler, Steven ;
Kim, Jaehon ;
Hausman, Michael R. .
JOURNAL OF SHOULDER AND ELBOW SURGERY, 2016, 25 (06) :1020-1026
[9]   Possible effects of mobilisation on acute post-operative pain and nociceptive function after total knee arthroplasty [J].
Lunn, T. H. ;
Kristensen, B. B. ;
Gaarn-Larsen, L. ;
Kehlet, H. .
ACTA ANAESTHESIOLOGICA SCANDINAVICA, 2012, 56 (10) :1234-1240
[10]  
MALONEY WJ, 1989, CLIN ORTHOP RELAT R, P117