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Predictive factors influencing fast track rehabilitation following primary total hip and knee arthroplasty.
MedLine Citation:
PMID:  19198860     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Fast track rehabilitation after primary total hip (THR) and total knee replacement (TKR) is gaining popularity. We performed a prospective clinical trial to identify predictive factors for successful fast track rehabilitation. METHODS: Between June 2005 and January 2006, 52 THR and 48 TKR were performed on consecutive patients off the local waiting list with no pre-selection or exclusion criteria. Patients underwent a fast track rehabilitation programme within a group-dynamic set-up aiming for discharge day 3 to 5 postoperatively. Demographic, clinical and social factors were analysed. RESULTS: Eighty-four percent (n = 44) of THR patients and 73% (n = 35) following TKR achieved the target discharge. Average discharge after THR was 5.4 and 5.5 days after TKR. Delayed discharge was mostly related to medical, social and organisational reasons. Age, 3 m-get-up-and-go-test (3 m-TGUGT), home situation and preoperative walking distance were the main predictors for the early discharge after THR; age, diagnosis, ASA class and preoperative pain medication were influential for TKR. Perioperative complication rates were within or below the national average. CONCLUSION: Successful fast track rehabilitation is possible without pre-selection and does not seem to compromise clinical safety. However, a good social and physiotherapy community set-up should be available. The identified predictive factors could be helpful to identify candidates for fast track rehabilitation.
Authors:
Michael Schneider; Ikuo Kawahara; Gail Ballantyne; Christine McAuley; Karen Macgregor; Ruth Garvie; Alistair McKenzie; Deborah Macdonald; Steffen J Breusch
Publication Detail:
Type:  Journal Article     Date:  2009-02-07
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  129     ISSN:  1434-3916     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1585-91     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, University of Edinburgh, New Royal Infirmary, Edinburgh, Scotland, UK.
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