Abstract
Aim: To demonstrate that a multidisciplinary protocol reduces both in-patient stay and the need for out-patient physiotherapy following minimally invasive (MIS) uni-condylar knee replacements (UKR).
Methods: The data for hospital stay was collated for a consecutive group of primary UKR at our institution during 2002. We then compared this with a consecutive group of patients seen in a dedicated physiotherapist run clinic, with the provision of brochures and a “patient experience video”, with input from nurses, physiotherapists, anaesthetists, and surgeons, as well as time of expected discharge. The data was compared between informed (dedicated pre-operative assessment and patient video) and uninformed patients (standard pre-operative care).
Results: Total of 57 patients were initially assessed and compared with 81 patients after introduction of specific pre-op care pathway. Average hospital stay was reduced from 3.7 days to 2.1 days, with 60% going home within 24 hours.
Discussion: By changing the preconception of long hospital stays after arthroplasty ingrained in patients and staff we have reduced hospital stay significantly. Major factors contributing to this include the team approach, patient and ward staff education, perceptions of discharge and the inclusion of specific local anaesthetic techniques, and a minimally invasive approach. Delays in discharge include the geography of the region.
Honorary Secretary – Mr Roger Smith. Correspondence should be addressed to BASK at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN
