Implementation of enhanced recovery after surgery in perioperative management of total knee arthroplasty

doi:10.3969/j.issn.2095-4344.1201

Abstract

Abstract:

BACKGROUND: Enhanced recovery after surgery refers to the improvement, optimization and combination of perioperative management measures to alleviate surgical trauma stress response, reduce postoperative complications, shorten hospitalization time, and achieve the goal of rapid recovery. This concept has been widely used in gastrointestinal surgery and has been paid much attention by orthopedics in recent years. Therefore, the rapid rehabilitation management of knee arthroplasty has become an issue of concern.

OBJECTIVE: To explore the effect of perioperative enhanced recovery after surgery on the rehabilitation in patients undergoing total knee arthroplasty.

METHODS: Thirty patients undergoing total knee arthroplasty received perioperative enhanced recovery after surgery from January to June 2018 (trial group), and 30 patients undergoing total knee arthroplasty received traditional perioperative management from July to December 2017 (control group). All patients have provided the informed consents and the trial protocol has been approved by the ethics committee of the hospital. The postoperative early rehabilitation efficacy was compared, including active flexion angle, Hospital for Special Surgery score, and Visual Analog Scale scores at rest and in activity. The unscheduled readmission rate and satisfaction at postoperative 30 days were recorded.

RESULTS AND CONCLUSION: (1) The active flexion angle at postoperative 3, 5 and 7 days and the Hospital for Special Surgery score at postoperative 1 and 3 months in the trial group were significantly higher than those in the control group (P < 0.05). (2) The Visual Analog Scale scores at rest and in activity at postoperative 6, 24 and 36 hours in the trial group were significantly lower than those in the control group (P < 0.05). (3) The unscheduled readmission rate in both two groups was zero. (4) Perioperative enhanced recovery after surgery could significantly improve the satisfaction (P < 0.01). (5) To conclude, perioperative enhanced recovery after surgery management can facilitate the early rehabilitation process in total knee arthroplasty, increase patients’ satisfaction and improve the medical service.

Key words: enhanced recovery after surgery, total knee arthroplasty, perioperative management, rehabilitation efficacy, Visual Analog Scale, active flexion angle, Hospital for Special Surgery score, the National Natural Science Foundation of china

CLC Number:

R459.9

Jin Jia, Xu Wei, Ai Hongzhen. Implementation of enhanced recovery after surgery in perioperative management of total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(16): 2467-2472.

Figures/Tables 7

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