Comparison of two accelerated clinical pathways -- after total knee replacement how fast can we really go?
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| Title: | Comparison of two accelerated clinical pathways -- after total knee replacement how fast can we really go? |
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| Authors: | Renkawitz T (AUTHOR), Rieder T (AUTHOR), Handel M (AUTHOR), Koller M (AUTHOR), Drescher J (AUTHOR), Bonnlaender G (AUTHOR), Grifka J (AUTHOR) |
| Source: | Clinical Rehabilitation. Mar2010, Vol. 24 Issue 3, p230-239. 10p. |
| Abstract: | Objective: To evaluate whether a further optimization of an existing accelerated clinical pathway protocol after total knee replacement is feasible and improves postoperative outcome. Design: Prospective, parallel group design. Setting: Orthopaedic University Medical Centre. Patients: A total of 143 patients, scheduled for unilateral primary total knee replacement under perioperative regional analgesia. Intervention: Sixty-seven patients received an optimized accelerated clinical pathway including patient-controlled regional analgesia pumps, ultra-early/doubled physiotherapy and motor-driven continuous passive motion machine units. Seventy-six patients received a standard accelerated clinical pathway. Main measures: Feasibility was defined as the proportion of patients successfully completing the assigned pathway. Early postoperative pain on a visual analogue scale, consumption of regional anaesthetics, knee range of motion, time out of bed, non-stop walking distance/stair climbing, circumference measurement and Knee Society Score on the operated leg. Possible discharge according to an own discharge checklist. Results: All patients assigned to both groups successfully completed this pathway. Patients in the optimized pathway showed significant benefits regarding stair climbing/walking distance/time out of bed/circumference measurements of the thigh/Knee Society function score on the fifth postoperative day and stair climbing/ circumference measurements of the thigh on the eighth postoperative day, and reduction of the consumption of regional anaesthetics. No significant reduction in length of stay was observed. Conclusions: Early postoperative functional process indicators tended to be higher within the optimized pathway group, but the main effects flattened over the course of the first eight postoperative days. [ABSTRACT FROM AUTHOR] |
| Copyright of Clinical Rehabilitation is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
| FullText | Links: – Type: pdflink Text: Availability: 0 |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 105139441 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Comparison of two accelerated clinical pathways -- after total knee replacement how fast can we really go? – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Renkawitz+T%22">Renkawitz T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rieder+T%22">Rieder T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Handel+M%22">Handel M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Koller+M%22">Koller M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Drescher+J%22">Drescher J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bonnlaender+G%22">Bonnlaender G</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Grifka+J%22">Grifka J</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Clinical+Rehabilitation%22">Clinical Rehabilitation</searchLink>. Mar2010, Vol. 24 Issue 3, p230-239. 10p. – Name: Abstract Label: Abstract Group: Ab Data: Objective: To evaluate whether a further optimization of an existing accelerated clinical pathway protocol after total knee replacement is feasible and improves postoperative outcome. Design: Prospective, parallel group design. Setting: Orthopaedic University Medical Centre. Patients: A total of 143 patients, scheduled for unilateral primary total knee replacement under perioperative regional analgesia. Intervention: Sixty-seven patients received an optimized accelerated clinical pathway including patient-controlled regional analgesia pumps, ultra-early/doubled physiotherapy and motor-driven continuous passive motion machine units. Seventy-six patients received a standard accelerated clinical pathway. Main measures: Feasibility was defined as the proportion of patients successfully completing the assigned pathway. Early postoperative pain on a visual analogue scale, consumption of regional anaesthetics, knee range of motion, time out of bed, non-stop walking distance/stair climbing, circumference measurement and Knee Society Score on the operated leg. Possible discharge according to an own discharge checklist. Results: All patients assigned to both groups successfully completed this pathway. Patients in the optimized pathway showed significant benefits regarding stair climbing/walking distance/time out of bed/circumference measurements of the thigh/Knee Society function score on the fifth postoperative day and stair climbing/ circumference measurements of the thigh on the eighth postoperative day, and reduction of the consumption of regional anaesthetics. No significant reduction in length of stay was observed. Conclusions: Early postoperative functional process indicators tended to be higher within the optimized pathway group, but the main effects flattened over the course of the first eight postoperative days. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Clinical Rehabilitation is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1177/0269215509353267 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 230 Titles: – TitleFull: Comparison of two accelerated clinical pathways -- after total knee replacement how fast can we really go? Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Renkawitz T – PersonEntity: Name: NameFull: Rieder T – PersonEntity: Name: NameFull: Handel M – PersonEntity: Name: NameFull: Koller M – PersonEntity: Name: NameFull: Drescher J – PersonEntity: Name: NameFull: Bonnlaender G – PersonEntity: Name: NameFull: Grifka J IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 03 Text: Mar2010 Type: published Y: 2010 Identifiers: – Type: issn-print Value: 02692155 Numbering: – Type: volume Value: 24 – Type: issue Value: 3 Titles: – TitleFull: Clinical Rehabilitation Type: main |
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