Aims. In-hospital
Introduction. Postoperative pain is a concern for patients undergoing Total Knee Arthroplasty (TKA) and plays an important role in opioid consumption,
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
Abstract. Background. There is a trend towards minimising
Introduction. We designed this study to compare 30-day complications and
Our aim in this audit was to determine whether intensive rehabilitation post-operatively influenced
Abstract. Introduction. Spinal local anaesthesia and opioids have long been used as peri-operative analgesia for patients undergoing arthroplasty procedures. However, intrathecal opioids are associated with numerous complications. ERAS. ®. society guidelines for elective knee replacement (2019) strongly discourage the use of spinal opioids. This study aims to report the impact of low-dose spinal and local infiltrative analgesia on patients undergoing elective knee replacement. Methodology. Retrospective cohort study of patients undergoing knee replacement under the ERAS protocol over 2 years, at a district general hospital under the care of a single surgeon. Results. A total of 80 knee replacements were included in the study (M38:F42, mean age=72.7, mean BMI=31, ASA: 1=8, 2=54, 3=18). 91% received neuroaxial anaesthesia, 89% without intrathecal opioids. Local infiltrative analgesia was used in 99% of patients. The mean
Introduction. The Rapid Recovery Program (RRP) is a holistic perioperative accelerated discharge process that aims to improve efficiency and quality of care, improve patient education, standardise protocols and pathways and encourage early mobilisation & discharge. Aims. To compare
Background. The evaluation and management of outcomes risk has become an essential element of a modern total joint replacement program. Our multidisciplinary team designed an evidence-based tool to address modifiable risk factors for adverse outcomes after primary hip and knee arthroplasty surgery. Methods. Our protocols were designed to identify, intervene, and mitigate risk through evidence-based patient optimization. Nurse navigators screened patients preoperatively, identified and treated risk factors, and followed patients for 90 days postoperatively. We compared patients participating in our optimization program (N=104) to both a historical cohort (N=193) and a contemporary cohort (N=166). Results. Risk factor identification and optimization resulted in lower hospital
Aim. The aim of this study was to determine the factors which were responsible for differences between patients achieving the Trust target of discharge on post-operative day 5 after a primary total knee replacement and those not achieving it, in the cohort of over 75 year olds. Methods and Results. Of all the patients undergoing a TKR at Addenbrooke's Hospital in 2008, those over 75 were identified (n=103). From the literature pre-, intra- and post-operative factors that had previously been shown to affect
In Scotland, the number of primary total knee replacements performed annually has been increasing steadily. The price of the implant is fixed but the
PURPOSE OF STUDY. We investigated the effect of weekend knee arthroplasty surgery on
Aims. Robotic-assisted total knee arthroplasty (RA-TKA) has been introduced to provide accurate bone cuts and help achieve the target knee alignment, along with symmetric gap balancing. The purpose of this study was to determine if any early clinical benefits could be realized following TKA using robotic-assisted technology. Methods. In all, 140 consecutive patients undergoing RA-TKA and 127 consecutive patients undergoing conventional TKA with minimum six-week follow-up were reviewed. Differences in visual analogue scores (VAS) for pain at rest and with activity, postoperative opiate usage, and
Early and accurate prediction of hospital length-of-stay
(LOS) in patients undergoing knee replacement is important for economic
and operational reasons. Few studies have systematically developed
a multivariable model to predict LOS. We performed a retrospective
cohort study of 1609 patients aged ≥ 50 years who underwent elective,
primary total or unicompartmental knee replacements. Pre-operative
candidate predictors included patient demographics, knee function,
self-reported measures, surgical factors and discharge plans. In
order to develop the model, multivariable regression with bootstrap
internal validation was used. The median LOS for the sample was
four days (interquartile range 4 to 5). Statistically significant
predictors of longer stay included older age, greater number of comorbidities,
less knee flexion range of movement, frequent feelings of being
down and depressed, greater walking aid support required, total
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Aims. The aim of this prospective multicentre study was to describe trends in
Abstract. Introduction. It is common practice for all patients to have postoperative bloods tests after total knee arthroplasty (TKA). However there have been significant improvement in perioperative care with arthroplasty surgery. As healthcare systems and providers strive towards a more efficient service we must re-consider whether such an intervention is necessary for all patients. Methodology. This retrospective study included all patients who underwent a primary unilateral TKA at a single tertiary arthroplasty centre during a 1 year period. Electronic medical records of 776 patients were reviewed for patient demographics,
Aims. Robotic arm-assisted surgery offers accurate and reproducible guidance in component positioning and assessment of soft-tissue tensioning during knee arthroplasty, but the feasibility and early outcomes when using this technology for revision surgery remain unknown. The objective of this study was to compare the outcomes of robotic arm-assisted revision of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA) versus primary robotic arm-assisted TKA at short-term follow-up. Methods. This prospective study included 16 patients undergoing robotic arm-assisted revision of UKA to TKA versus 35 matched patients receiving robotic arm-assisted primary TKA. In all study patients, the following data were recorded: operating time, polyethylene liner size, change in haemoglobin concentration (g/dl),
Abstract. Introduction. In patients with bilateral unicompartmental knee osteoarthritis, simultaneous bilateral surgery is cost effective, with both patient-specific and wider socioeconomic benefits. There are concerns however regarding higher complication rates with bilateral knee surgery. This study compares simultaneous bilateral unicompartmental knee arthroplasty (UKA), to single side UKA in terms of complications and outcomes. Methodology. This is a retrospective case-control study of single side medial UKA patients (controls) and simultaneous bilateral medial UKA patients (cases). All patients underwent surgery between 2018 and 2022 by a single surgeon. The two cohorts were compared for perioperative blood loss (PBL),
Aims. The primary aim of the study was to perform an analysis to identify the cost per quality-adjusted life-year (QALY) of robot-assisted unicompartmental knee arthroplasty (rUKA) relative to manual total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) for patients with isolated medial compartment osteoarthritis (OA) of the knee. Secondary aims were to assess how case volume and
Aims. The rate of day-case total knee arthroplasty (TKA) in the UK is currently approximately 0.5%. Reducing