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Overnight joint replacement surgery: a pilot Australian study
Author(s) -
Qurashi Sol,
Chinnappa Jason,
Aktas Sam,
Dabboussi Abdul Majid,
Rahman Md Bayzidur
Publication year - 2022
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.17977
Subject(s) - medicine , perioperative , joint replacement , adverse effect , knee replacement , rehabilitation , patient satisfaction , protocol (science) , total hip replacement , hip replacement , physical therapy , emergency medicine , arthroplasty , surgery , anesthesia , alternative medicine , pathology
Background With a stretched healthcare system and elective surgery backlog, measures to improve efficiency and decrease costs associated with surgical procedures need to be prioritized. This study compares the benefits of multi‐disciplinary involvement in an enhanced recovery after surgery (ERAS) protocol‐led overnight model following total hip replacement (THR) and total knee replacement (TKR). Methods Patients in each of two private hospitals undergoing THR or TKR were prospectively enrolled. One hospital (Overnight) was fully committed to the ERAS protocol implementation on all levels and formed the treatment group while in the other hospital (control), patients only had the anaesthetic and operative procedure as part of the ERAS protocol but did not follow the perioperative measures of the protocol. Outcomes on hospital length of stay (LOS), inpatient rehabilitation, functional outcomes, satisfaction, adverse events and readmission rates were investigated. Results Median LOS in the Overnight group was significantly smaller than in the control group (1 vs. 3 days, P < 0.0001). The Overnight group had lower rates of inpatient rehabilitation utilization (4% vs. 41.2%, P < 0.0001), similar improvements in functional hip and knee scores and no increased rate of adverse events or readmission. All patients in both groups were satisfied with their treatment. Conclusion Overnight THR and TKR can safely be performed in the majority of patients, with a multi‐disciplinary approach protocol and involvement of all perioperative stakeholders.