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01-01-2021 | Original Paper

Fast-track procedures after primary total knee arthroplasty reduce hospital stay by unselected patients: a prospective national multi-centre study

Authors: Jean-Yves Jenny, Cyril Courtin, Philippe Boisrenoult, Julien Chouteau, Pierre Henky, Claude Schwartz, Aymard de Ladoucette, Société Française de Chirurgie Orthopédique et Traumatologique (SOFCOT)

Published in: International Orthopaedics | Issue 1/2021

Abstract

Purpose

The aim of this study was to evaluate the impact of fast-track procedures (FTPs) on length of hospital stay after primary total knee arthroplasty (TKA) in a prospective, national, multicentric analysis. The innovative point was that no patient selection was used. The hypothesis was that FTPs reduce hospital stay after primary TKA for non-traumatic conditions compared with the national database.

Methods

An observational prospective study was conducted in ten centres throughout France. A total of 839 patients included in FTPs were followed up for three months. The average LOS, direct return home rate, unscheduled re-admission rate, and re-intervention rate were compared with those in the national database (93,329 TKAs). Knee society and Oxford score were collected.

Results

The mean LOS was 4.4 ± 3.3 days, while the national base LOS was 6.4 ± 3.1 days (p < 0.001). A total of 560 patients (66.7%) were able to return home, compared with 47,617 (49.6%) in the national database (p < 0.001). Thirty-five patients (4.2%) were re-admitted within 90 days of the intervention, compared with 10,399 (10.8%) in the national database (p < 0.001). Seventeen patients (2.0%) were re-operated upon within 90 days after the TKA, compared with 529 (0.5%) in the national database (p < 0.05).

Conclusion

The FTPs used by unselected patients allowed a significant decrease in the mean LOS and in the rate of re-admission and a significant increase of the rate of direct home return after primary TKA compared with the national database. The significant increase in the re-operation rate warrants further investigation. However, FTP should become the standard of care after this intervention.

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Title: Fast-track procedures after primary total knee arthroplasty reduce hospital stay by unselected patients: a prospective national multi-centre study
Authors: Jean-Yves Jenny
Cyril Courtin
Philippe Boisrenoult
Julien Chouteau
Pierre Henky
Claude Schwartz
Aymard de Ladoucette
Société Française de Chirurgie Orthopédique et Traumatologique (SOFCOT)
Publication date: 01-01-2021
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 1/2021
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-020-04680-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Fast-track procedures after primary total knee arthroplasty reduce hospital stay by unselected patients: a prospective national multi-centre study

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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