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Arch Orthop Trauma Surg. 2018 Sep;138(9):1305-1316. doi: 10.1007/s00402-018-3001-2. Epub 2018 Jul 19.

Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery: a randomized controlled pilot study with 5-year follow-up.

Author information

1
Department of Orthopaedic Surgery, CORAL-Centre for Orthopaedic Research Alkmaar, Noordwest Ziekenhuisgroep Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands. b.l.fransen@nwz.nl.
2
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands. b.l.fransen@nwz.nl.
3
Department of Orthopaedic Surgery, CORAL-Centre for Orthopaedic Research Alkmaar, Noordwest Ziekenhuisgroep Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, The Netherlands.
4
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.

Abstract

INTRODUCTION:

Fast-track protocols (FP) are used more and more to optimize results after total knee arthroplasty (TKA). Many studies evaluating FP in TKA concentrate on clinical outcome and medium to long-term results. Since discharge from hospital after TKA is achieved increasingly quicker worldwide using FP in an increasingly younger and active patient population, the effects of FP on functional outcome in the first days after TKA become more important. The purpose of the current study was to compare FP with a regular joint care protocol (RP), with an emphasis on the first 7 days after surgery.

MATERIALS AND METHODS:

A non-blinded randomized controlled clinical pilot study was performed with 25 patients assigned to a FP group and 25 patients assigned to a RP group. Primary outcome was functional outcome, clinical outcome, pain, and complications for each day in the first week after surgery. Patients were followed up to 5 years after surgery.

RESULTS:

Significantly lower VAS scores for knee pain, faster Timed-Up and Go test times and more mobility on functional tests were seen on several days in the first week in the FP group compared to the RP group. Few other significant differences were found at 2, 6 weeks, and no significant differences were found at 12 weeks and 1, 2 and 5 years after surgery.

CONCLUSIONS:

Fast-track protocol for primary TKA showed significantly lower knee pain scores and improved functional outcome in the first 7 days after TKA compared to a regular protocol.

KEYWORDS:

Fast-track protocol; Functional outcome; Total knee arthroplasty

PMID:
30027483
PMCID:
PMC6096572
DOI:
10.1007/s00402-018-3001-2
[Indexed for MEDLINE]
Free PMC Article

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