Low readmission and reattendance rate in day-case total knee arthroplasties-Reference-Cited by-同舟云学术

Low readmission and reattendance rate in day-case total knee arthroplasties

Published:2023-08-22 Issue:8 Volume:4 Page:621-627
ISSN:2633-1462
Container-title:Bone & Joint Open
language:en
Short-container-title:Bone Jt Open

Author:

Fishley William G.¹²^ORCID,Paice Sarah¹,Iqbal Haaris¹,Mowat Stephen³,Kalson Nicholas S.¹⁴,Reed Mike¹²,Partington Paul¹,Petheram Timothy G.¹

Affiliation:

1. Northumbria Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Wansbeck General Hospital, Ashington, UK

2. University of York, York, UK

3. Northumbria Anaesthetics, Northumbria Healthcare NHS Foundation Trust, Wansbeck General Hospital, Ashington, UK

4. Newcastle University, Newcastle upon Tyne, UK

Abstract

AimsThe rate of day-case total knee arthroplasty (TKA) in the UK is currently approximately 0.5%. Reducing length of stay allows orthopaedic providers to improve efficiency, increase operative throughput, and tackle the rising demand for joint arthroplasty surgery and the COVID-19-related backlog. Here, we report safe delivery of day-case TKA in an NHS trust via inpatient wards with no additional resources.MethodsDay-case TKAs, defined as patients discharged on the same calendar day as surgery, were retrospectively reviewed with a minimum follow-up of six months. Analysis of hospital and primary care records was performed to determine readmission and reattendance rates. Telephone interviews were conducted to determine patient satisfaction.ResultsSince 2016, 301/7350 TKAs (4.1%) in 290 patients at our institution were discharged on the day of surgery. Mean follow-up was 31.4 months (6.2 to 70.0). In all, 28 patients (9.3%) attended the emergency department or other acute care settings within 90 days of surgery, most often with wound concerns or leg swelling; six patients (2.0%) were readmitted. No patients underwent a subsequent revision procedure, and there were no periprosthetic infections. Two patients (0.7%) underwent secondary patella resurfacing, and one patient underwent arthroscopic arthrolysis after previous manipulation under anaesthetic (MUA). Three patients (1.0%) underwent MUA alone. Primary care consultation records, available for 206 patients, showed 16 patients (7.8%) contacted their general practitioner within two weeks postoperatively; two (1.0%) were referred to secondary care. Overall, 115/121 patients (95%) telephoned stated they would have day-case TKA again.ConclusionDay-case TKA can be safely delivered in the NHS with no additional resources. We found low incidence of contact with primary and secondary care in the postoperative period, and high patient satisfaction.Cite this article: Bone Jt Open 2023;4(8):621–627.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Surgery,Orthopedics and Sports Medicine

Link

https://boneandjoint.org.uk/doi/10.1302/2633-1462.48.BJO-2023-0043.R1/pdf

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