PMID- 26130425
OWN - NLM
STAT- MEDLINE
DCOM- 20180524
LR  - 20220331
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 25
IP  - 9
DP  - 2017 Sep
TI  - Outpatient surgery for unicompartmental knee arthroplasty is effective and safe.
PG  - 2659-2667
LID - 10.1007/s00167-015-3680-y [doi]
AB  - PURPOSE: There has been increasing interest in accelerated programs for knee 
      arthroplasty. We examined the efficacy and safety of an outpatient surgery (OS) 
      pathway in patients undergoing unicompartmental knee arthroplasty (UKA). METHODS: 
      This case-controlled study evaluates patients operated for UKA in an OS pathway 
      (n = 20) compared to rapid recovery (RR), the current standard (n = 20). We 
      investigated whether patients could be discharged on the day of surgery, 
      resulting in comparable or better outcome by means of adverse events (AEs) in 
      terms of pain (numerical rating scale, NRS), incidences of postoperative nausea 
      and vomiting (PONV) and opiate use (<48 h postoperatively), complication and 
      readmission rates (<3 months postoperatively). Patient-reported outcome measures 
      (PROMS) were obtained preoperatively and 3 months postoperatively. RESULTS: 
      Postoperative pain (NRS > 5) was the most common reason for prolonged hospital 
      stay in the OS pathway. Eighty-five per cent of the patients were discharged on 
      the day of surgery, whereas 95 % of the patients were discharged on postoperative 
      day 3 in the RR pathway. Overall, median pain scores in both pathways did not 
      exceed a NRS score of 5, without significant differences (RR vs. OS) in the 
      number of patients with PONV (4 vs. 2) and opiate use (11 vs. 9) <48 h 
      postoperatively. At 3 months postoperatively, no significant differences were 
      found for AEs and PROMS between both pathways. CONCLUSION: The results of this 
      study illustrates that an OS pathway for UKA is effective and safe with 
      acceptable clinical outcome. Well-established and adequate standardized 
      protocols, inclusion and exclusion criteria and a change in mindset for both the 
      patient and the multidisciplinary team are the key factors for the implementation 
      of an OS pathway. LEVEL OF EVIDENCE: Case-control study, Level III.
FAU - Kort, Nanne P
AU  - Kort NP
AD  - Department of Orthopaedic Surgery, Atrium-Orbis Medical Centre, Location Orbis, 
      Dr. H vd Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands. n.kort@imuka.eu.
FAU - Bemelmans, Yoeri F L
AU  - Bemelmans YFL
AD  - Department of Orthopaedic Surgery, Atrium-Orbis Medical Centre, Location Orbis, 
      Dr. H vd Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands.
FAU - Schotanus, Martijn G M
AU  - Schotanus MGM
AD  - Department of Orthopaedic Surgery, Atrium-Orbis Medical Centre, Location Orbis, 
      Dr. H vd Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands.
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
DEP - 20150701
PL  - Germany
TA  - Knee Surg Sports Traumatol Arthrosc
JT  - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JID - 9314730
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Ambulatory Surgical Procedures
MH  - Arthroplasty, Replacement, Knee/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Hemiarthroplasty/*methods
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Pain, Postoperative/diagnosis/etiology/therapy
MH  - Patient Reported Outcome Measures
MH  - Pilot Projects
OTO - NOTNLM
OT  - Early mobilization
OT  - Outpatient surgery
OT  - PONV
OT  - Pain management
OT  - Partial knee arthroplasty
OT  - Short-stay
OT  - Unicompartmental knee arthroplasty
EDAT- 2015/07/02 06:00
MHDA- 2018/05/25 06:00
CRDT- 2015/07/02 06:00
PHST- 2014/11/04 00:00 [received]
PHST- 2015/06/08 00:00 [accepted]
PHST- 2015/07/02 06:00 [pubmed]
PHST- 2018/05/25 06:00 [medline]
PHST- 2015/07/02 06:00 [entrez]
AID - 10.1007/s00167-015-3680-y [pii]
AID - 10.1007/s00167-015-3680-y [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2017 Sep;25(9):2659-2667. doi: 
      10.1007/s00167-015-3680-y. Epub 2015 Jul 1.