The effect of early mobility in patients after Total Knee Replacement on hospital length of stay, pain and function: A randomised control trial

2017 ◽  
Vol 38 (2) ◽  
pp. 121-125
Author(s):  
Sathiyapriya Gnanakumaran ◽  
Frank Li ◽  
Megan White ◽  
Natalie Shiel ◽  
Peter Walker ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Randomised Control Trial ◽  
Early Mobility ◽  
Total Knee ◽  
And Function

scholarly journals Total Knee Replacement and the Effect of Technology on Cocreation for Improved Outcomes and Delivery: Qualitative Multi-Stakeholder Study (Preprint)

2017 ◽  
Author(s):  
Yasmin van Kasteren ◽  
Jill Freyne ◽  
M Sazzad Hussain
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Digital Technology ◽  
Care Delivery ◽  
Health Care Service ◽  
Hospital Length Of Stay ◽  
Patient Centered ◽  
Total Knee

BACKGROUND The growth in patient-centered care delivery combined with the rising costs of health care have perhaps not unsurprisingly been matched by a proliferation of patient-centered technology. This paper takes a multistakeholder approach to explore how digital technology can support the cocreation of value between patients and their care teams in the delivery of total knee replacement (TKR) surgery, an increasingly common procedure to return mobility and relieve pain for people suffering from osteoarthritis. OBJECTIVE The aim of this study was to investigate communications and interactions between patients and care teams in the delivery of TKR to identify opportunities for digital technology to add value to TKR health care service by enhancing the cocreation of value. METHODS A multistakeholder qualitative study of user needs was conducted with Australian stakeholders (N=34): surgeons (n=12), physiotherapists (n=3), patients (n=11), and general practitioners (n=8). Data from focus groups and interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS Encounters between patients and their care teams are information-rich but time-poor. Results showed seven different stages of the TKR journey that starts with referral to a surgeon and ends with a postoperative review at 12 months. Each stage of the journey has different information and communication challenges that can be enhanced by digital technology. Opportunities for digital technology include improved waiting list management, supporting and reinforcing patient retention and recall of information, motivating and supporting rehabilitation, improving patient preparation for hospital stay, and reducing risks and anxiety associated with postoperative wound care. CONCLUSIONS Digital technology can add value to patients’ care team communications by enhancing information flow, assisting patient recall and retention of information, improving accessibility and portability of information, tailoring information to individual needs, and by providing patients with tools to engage in their own health care management. For care teams, digital technology can add value through early detection of postoperative complications, proactive surveillance of health data for postoperative patients and patients on waiting lists, higher compliance with rehabilitation programs, and reduced length of stay. Digital technology has the potential to improve patient satisfaction and outcomes, as well as potentially reduce hospital length of stay and the burden of disease associated with postoperative morbidity.

scholarly journals Changes in foot posture and function following total knee replacement surgery

2012 ◽  
Vol 5 (S1) ◽  
Author(s):  
Pazit Levinger ◽  
Hylton B Menz ◽  
Adam D Morrow ◽  
Julian A Feller ◽  
John R Bartlett ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Foot Posture ◽  
Total Knee ◽  
And Function

scholarly journals How do patients appraise satisfaction, and pain and function outcomes after total knee replacement? A qualitative investigation

2019 ◽  
Vol 27 ◽  
pp. S309-S310
Author(s):  
N.-R. Klem ◽  
S. Bunzli ◽  
M. Dowsey ◽  
R. Schutze ◽  
P. O'Sullivan ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Qualitative Investigation ◽  
Total Knee ◽  
And Function

Factors Affecting Hospital Length of Stay following Total Knee Replacement: A Retrospective Analysis in a Regional Hospital

2019 ◽  
Author(s):  
Corey Scholes ◽  
MacDougal Cowley ◽  
Milad Ebrahimi ◽  
Michel Genon ◽  
Samuel J. Martin
Keyword(s):  
Length Of Stay ◽  
Hospital Readmission ◽  
Postoperative Management ◽  
Hospital Length ◽  
Regional Hospital ◽  
Hospital Length Of Stay ◽  
Care Providers ◽  
Total Knee ◽  
Management Factors ◽  
Over Time

AbstractIn an effort to reduce hospital length of stay (LoS) following total knee arthroplasty (TKA), patient management strategies have evolved over time. The aims of this study were threefold: first, to quantify the reduction in LoS for TKA in a regional hospital; second, to identify the patient, surgical and management factors associated with hospital LoS; and lastly, to assess the change in complications incidence and hospital readmission as a function of LoS. A retrospective chart review was conducted on a consecutive series of primary and revision TKAs from January 2012 to March 2018. Factors describing patient demographics, as well as preoperative, intraoperative, surgical, and postoperative management, were extracted from paper and electronic medical records by a team of reviewers. Multivariate linear regression was performed to assess the association between these factors and LoS. In total, 362 procedures were included, which were reduced to 329 admissions once simultaneous bilateral procedures were taken into account. Median LoS reduced significantly (p = 0.001) from 6 to 2 days over the period of review. A stepwise regression analysis identified patient characteristics (age, gender, comorbidities, discharge barriers), perioperative management (anesthesia type), surgical characteristics (approach, alignment method), and postoperative management (mobilization timing, postoperative narcotic use, complication prior to discharge) as factors explaining 58.3% of the variance in LoS. Representation to emergency (6%) and hospital readmission (3%) remained low for the reviewed period. Efforts to reduce hospital LoS following TKA within a regional hospital setting can be achieved over time without significant increases in the rate or severity of complications or representation to acute care and subsequent readmission. The findings establish the role of patient, surgical and management factors in the context of agreed discharge criteria between care providers.

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