Aims. Postoperative
Aims. Day-case arthroplasty is gaining popularity in Europe. We report outcomes from the first 12 months following implementation of a day-case pathway for unicompartmental knee arthroplasty (UKA) and total hip arthroplasty (THA) in an NHS hospital. Methods. A total of 47 total hip arthroplasty (THA) and 24 unicompartmental knee arthroplasty (UKA) patients were selected for the day-case arthroplasty pathway, based on preoperative fitness and agreement to participate. Data were likewise collected for a matched control group (n = 58) who followed the standard pathway three months prior to the implementation of the day-case pathway. We report same-day discharge (SDD) success, reasons for delayed discharge, and patient-reported outcomes. Overall
Aims. The aim of this study is to assess the impact of a pilot enhanced recovery after surgery (ERAS) programme on
Aims. In-hospital
Aims. In countries with social healthcare systems, such as Canada, patients may experience long wait times and a decline in their health status prior to their operation. The aim of this study is to explore the association between long preoperative wait times (WT) and acute hospital
Abstract. Background. The European population is consistently getting older and this trend is expected to continue with fastest rise seen in those over 85 years old. As a consequence there will be more nonagenarians (over 90 years old) having lower limb arthroplasty. Objectives. To compare the
Introduction. The enhanced recovery after surgery (ERAS) concept in arthroplasty surgery has led to a reduction in postoperative
Introduction. There is a drive to reduce
Introduction. Adjusting an external fixator can be a daunting process for patients. Despite comprehensive training, patients often request supervision for the initial adjustments which may result in a prolonged hospital stay. Following the introduction of telemedicine during the pandemic we believed that this could be utilised to support patients with their fixator adjustments. A quality improvement project was implemented to assess and evaluate a change in practice from existing Face to Face support to a telemedicine format. The aim of the project was to reduce median
Aims. Elective orthopaedic services have had to adapt to significant system-wide pressures since the emergence of COVID-19 in December 2019.
Reduction of
Early mobilization within the first 12 hours (day zero) of total joint arthroplasty (TJA) has been shown to reduce
We examined the effect of age, gender, body mass index (BMI), medical co-morbidity as represented by the American Society of Anaesthesiologists (ASA) grade, social deprivation, nursing practice, surgical approach, length of incision, type of prosthesis and duration of surgery on
We examined the effect of age, gender, body mass index (BMI), medical comorbidity as represented by the American Society of Anaesthesiologists (ASA) grade, social deprivation, nursing practice, surgical approach, length of incision, type of prosthesis and duration of surgery on
Recent studies have described safe outcomes for short-stays in the hospital after total shoulder arthroplasty. The purpose of this study is to identify pre-operative and operative risk factors for hospital admissions exceeding 24 hours. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried from 2006 to 2016 for the current procedural terminology (CPT) billing code related to total shoulder arthroplasty. Patients were then grouped as either having a
Provision of prehabilitation prior to total knee arthroplasty (TKA) through a digital mobile application is a novel concept. Our research evaluates a resource effective and cost effective method of delivering prehabilitation. The primary aim of our research is to determine whether provision of prehabilitation through a mobile digital application impacts inpatient LOS after TKA. The secondary objective is to understand the effect of digital prehabilitation on hospital costs. An observational, retrospective analysis was performed on a consecutive case series of 64 patients who underwent TKA by a single surgeon over a 21 month period. Exercise provision varied from 3 months to 2 weeks prior to TKA. The outcomes of rehabilitation
This study was designed to compare
Background. The ability to identify those at risk for longer inpatient stay helps providers with postoperative planning and patient expectations. Decreasing
Introduction. Provision of prehabilitation prior to total knee arthroplasty (TKA) through a digital mobile application is a novel concept. The primary aim of our research is to determine whether provision of prehabilitation through a mobile digital application impacts
Introduction: Hypothesis: Patients undergoing operations at the end of the week are disadvantaged by the lack of weekend physiotherapy. Aim: To test the hypothesis by review of a single surgeon series of patients identifying factors affecting the post-operative
Aim: To determine the
Background. Navigated THA is a new procedure in Thailand that has been performed since 2012. The previous studies have reported that navigated THA was a safe, reliable procedure that resulted in a more consistent cup placement compared to the conventional free hand technique and decreased complications of THA, especially dislocation. Perioperative protocols are based on the surgeon's concern about stability of the prosthesis and the patient's health condition. Assuming that the navigator can improve the alignment and stability of THA, the time to start rehabilitation and the post operative
Arthroplasties are widely performed to improve mobility and quality of life for symptomatic knee/hip osteoarthritis patients. With increasing rates of Total Joint Replacements in the United Kingdom, predicting
Hip fracture patients are vulnerable to delirium. This study examined the associations between delirium and outcomes including mortality,
A prospective audit was carried out to analyse the relationship between time to surgery, number of co-morbidities and
In patients with an ankle fracture initial delay to operation because of time constraints is often prolonged because swelling precludes surgery for some days. We made use of a year long prospective audit of 2000 trauma patients to analyse the effect of delay to surgery on
Introduction. Postoperative pain is a concern for patients undergoing Total Knee Arthroplasty (TKA) and plays an important role in opioid consumption,
Single level discectomy (SLD) is one of the most commonly performed spinal surgery procedures. Two key drivers of their cost-of-care are duration of surgery (DOS) and postoperative
Introduction: Increasingly, clinical pathways and fast-track protocols are reducing hospital in-patient stay following elective joint replacement surgery. In order to improve efficiency in our unit, we undertook a prospective observational study to identify pre–and peri-operative factors associated with increased
Introduction. Social determinants of health (SDOH) may contribute markedly to the total cost of care (COC) for patients undergoing elective total knee arthroplasty (TKA). This study investigated the association between demographics, health status, and SDOH on
Introduction: There are a number of publications in the literature on managing post-operative pain and early rehabilitation after primary total hip replacement (THR). However, there has been very little work in the literature to study the influence of the anaesthetic technique used on the post-operative
Aims. While interdisciplinary protocols and expedited surgical treatment improve the management of hip fractures in the elderly, the impact of such interventions on patients specifically undergoing arthroplasty for a femoral neck fracture is not clear. We sought to evaluate the efficacy of an interdisciplinary protocol for the management of patients with a femoral neck fracture who are treated with an arthroplasty. Methods. In 2017, our institution introduced a standardized interdisciplinary hip fracture protocol. We retrospectively reviewed adult patients who underwent hemiarthroplasty (HA) or total hip arthroplasty (THA) for femoral neck fracture between July 2012 and March 2020, and compared patient characteristics and outcomes between those treated before and after the introduction of the protocol. Results. A total of 157 patients were treated before the introduction of the protocol (35 (22.3%) with a THA), and 114 patients were treated after its introduction (37 (32.5%) with a THA). The demographic details and medical comorbidities were similar in the two groups. Patients treated after the introduction of the protocol had a significantly reduced median time between admission and surgery (22.8 hours (interquartile range (IQR) 18.8 to 27.7) compared with 24.8 hours (IQR 18.4 to 43.3) (p = 0.042), and a trend towards a reduced mean time to surgery (24.1 hours (SD 10.7) compared with 46.5 hours (SD 165.0); p = 0.150), indicating reduction in outliers. Patients treated after the introduction of the protocol had a significantly decreased rate of major complications (4.4% vs 17.2%; p = 0.005), decreased median hospital
Our aim was to determine the effect of delay to surgery on the time to discharge, in-hospital death, the presence of major and minor medical complications and the incidence of pressure sores in patients with a fracture of the hip. All patients admitted to Vancouver General Hospital with this injury between 1998 and 2001 inclusive were identified from our trauma registry. A review of the case notes was performed to determine the delay in time from admission to surgery, age, gender, type of fracture and medical comorbidities. A time-to-event analysis was performed for
AIM. To evaluate patient outcomes in surgically managed ankle fractures with respect to fracture pattern, timing of surgery and
In-hospital
Introduction. The current study reports on the impact of immediate mobilization of patients treated by tissue-preserving, computer-assisted total hip arthroplasty on
Introduction: Although there are a number of publications in the literature on managing post-operative pain and early rehabilitation after surgery in general, there has been little work on the influence of anaesthetic technique on the post-operative
The aim of this study was to evaluate the impact of a preoperative education programme on
Abstract. Background. There is a trend towards minimising
Introduction. We designed this study to compare 30-day complications and
The burden of hospital
Background Hip fracture is a common clinical problem that leads to considerable morbidity and mortality in the United Kingdom. Recommendations in our hospital suggest that elderly patients suffering from these fractures should have surgery within two calendar days from admission. Methods From August 2002 to July 2003, we studied 407 patients over the age of 65 who had a fracture of the hip. (Cases were recorded prospectively in our department trauma database). This was to determine the effect of operative delay and patients age on in-hospital mortality and on post operative
Purpose: The aim of this study was to compare the results and
Introduction. Early rehabilitation and discharge following minimally-invasive total hip arthroplasty has potential risks including the possibility that patients may become progressively anemic at home. The current study assess the use of pre-emptive autologous blood transfusion on the
Many hospitals and orthopaedic surgery teams across Canada have instituted quality improvement (QI) programs for hip and knee arthroplasty. One of the common goals is to reduce hospital
Total knee and hip arthroplasty (TKA and THA) are two of the highest volume and resource intensive surgical procedures. Key drivers of the cost of surgical care are duration of surgery (DOS) and postoperative inpatient
To describe the longitudinal trends in patients with obesity and Metabolic Syndrome (MetS) undergoing TKA and the associated impact on complications and
A longer stay in the hospital after primary total hip replacement is consistent with an increased morbidity and slower recovery for patients. In addition, it is among the more costly aspects of a total joint replacement. A process, which reduces the
Introduction. With the removal of total hip arthroplasty (THA) from the Centers for Medicare & Medicaid Services (CMS) inpatient-only list, understanding predictors of
Aims. Delirium is associated with adverse outcomes following hip fracture, but the prevalence and significance of delirium for the prognosis and ongoing rehabilitation needs of patients admitted from home is less well studied. Here, we analyzed relationships between delirium in patients admitted from home with 1) mortality; 2) total