Dolleman G1, Hoogeboom T2, Steenbruggen R1
1Isala Clinic, Physiotherapy, Zwolle, Netherlands, 2Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands
Background: Total knee arthroplasty (TKA) is a common surgery, especially in the elderly population. Nowadays a lot of hospitals use the concept of Fast Track to optimize the perioperative care for total knee arthroplasty. The main goal of Fast Track is to let patients recover faster, reduce the length of stay and improve patients' satisfaction (Husted et al., 2012). Another purpose of the Fast Track procedure is to provide the patient with more individualized care and physical therapy (Husted et al., 2012).
In the Isala Clinic (Zwolle, the Netherlands) Fast Track was introduced in 2015. In order to reduce the length of stay, patients need to be self-reliant as soon as possible. To do so, it is important that patients are ambulatory right after surgery, although this is not always achieved.
Purpose: The purpose of this study is to investigate if, and if so, which pre- and peri-operative factors are related to patients' ability to ambulate a few hours after total knee replacement.
Methods: A database was set up to gather the required data. The content of the database was based on a literature search and interviews with several colleagues from different hospitals and comprised of the following independent variables: sex, age, body mass index, the physical condition of the patient by using the ASA (American Society of Anesthesiologists) score, having a partner, duration of surgery, type of anesthetics and if a patient is already walking with a walking aid. All the data is gathered from February 2015 to November 2016 during standard procedures using Research Manager. After data extraction and cleaning, we used univariate and multivariable logistic regression analyses to determine which of the independent variables were related to early ambulation.
Results: The database consisted of 265 cases. Sex, having a partner and duration of surgery had a univariate relationship (P 0.20) with early ambulation. Multivariable modeling demonstrated that sex was the only variable that was statistically significantly related to walking or not walking a few hours after surgery (Odds Ratio (95%-CI): 1.81 (1.06 - 3.08), p 0.01); meaning that women significantly more often did not walk right after surgery. Other factors appeared to play no clear role.
Conclusion(s): In the Fast Track total knee surgery, it seems that being a woman is predictive for not walking a few hours after surgery. Other factors seem to play no clear role in predicting walking or not walking a few hours after surgery.
Implications: Further research is necessary to determine if being a woman is really predictive for not walking a few hours after surgery or perhaps that not walking is more associated with a sex-specific predetermined idea.
Keywords: Fast Track, Total Knee Arthroplasty, Predictability
Funding acknowledgements: This work was not funded.
In the Isala Clinic (Zwolle, the Netherlands) Fast Track was introduced in 2015. In order to reduce the length of stay, patients need to be self-reliant as soon as possible. To do so, it is important that patients are ambulatory right after surgery, although this is not always achieved.
Purpose: The purpose of this study is to investigate if, and if so, which pre- and peri-operative factors are related to patients' ability to ambulate a few hours after total knee replacement.
Methods: A database was set up to gather the required data. The content of the database was based on a literature search and interviews with several colleagues from different hospitals and comprised of the following independent variables: sex, age, body mass index, the physical condition of the patient by using the ASA (American Society of Anesthesiologists) score, having a partner, duration of surgery, type of anesthetics and if a patient is already walking with a walking aid. All the data is gathered from February 2015 to November 2016 during standard procedures using Research Manager. After data extraction and cleaning, we used univariate and multivariable logistic regression analyses to determine which of the independent variables were related to early ambulation.
Results: The database consisted of 265 cases. Sex, having a partner and duration of surgery had a univariate relationship (P 0.20) with early ambulation. Multivariable modeling demonstrated that sex was the only variable that was statistically significantly related to walking or not walking a few hours after surgery (Odds Ratio (95%-CI): 1.81 (1.06 - 3.08), p 0.01); meaning that women significantly more often did not walk right after surgery. Other factors appeared to play no clear role.
Conclusion(s): In the Fast Track total knee surgery, it seems that being a woman is predictive for not walking a few hours after surgery. Other factors seem to play no clear role in predicting walking or not walking a few hours after surgery.
Implications: Further research is necessary to determine if being a woman is really predictive for not walking a few hours after surgery or perhaps that not walking is more associated with a sex-specific predetermined idea.
Keywords: Fast Track, Total Knee Arthroplasty, Predictability
Funding acknowledgements: This work was not funded.
Topic: Orthopaedics; Disability & rehabilitation
Ethics approval required: No
Institution: Isala Clinic (Zwolle, the Netherlands)
Ethics committee: Medical Ethical Board
Reason not required: Ethics approval was not required because all data are standard collected data and no additional information or efforts were asked from the patients
All authors, affiliations and abstracts have been published as submitted.
