The constraints on day-case total knee arthroplasty: the fastest fast track
Research output: Contribution to journal › Review › Research › peer-review
Total knee arthroplasty (TKA) is a major orthopaedic intervention. The length of a patient's stay has been progressively reduced with the introduction of enhanced recovery protocols: day-case surgery has become the ultimate challenge. This narrative review shows the potential limitations of day-case TKA. These constraints may be social, linked to patient's comorbidities, or due to surgery-related adverse events (e.g. pain, post-operative nausea and vomiting, etc.). Using patient stratification, tailored surgical techniques and multimodal opioid-sparing analgesia, day-case TKA might be achievable in a limited group of patients. The younger, male patient without comorbidities and with an excellent social network around him might be a candidate. Demographic changes, effective recovery programmes and less invasive surgical techniques such as unicondylar knee arthroplasty, may increase the size of the group of potential day-case patients. The cost reduction achieved by day-case TKA needs to be balanced against any increase in morbidity and mortality and the cost of advanced follow-up at a distance with new technology. These factors need to be evaluated before adopting this ultimate 'fast-track' approach.
Original language | English |
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Journal | The Bone & Joint Journal |
Volume | 97-B |
Issue number | 10 Suppl A |
Pages (from-to) | 40-4 |
Number of pages | 5 |
ISSN | 2049-4394 |
DOIs | |
Publication status | Published - Oct 2015 |
- Ambulatory Surgical Procedures, Arthroplasty, Replacement, Knee, Humans, Length of Stay, Perioperative Care, Postoperative Complications, Risk Assessment
Research areas
ID: 162839770