Role of preoperative pain, muscle function, and activity level in discharge readiness after fast-track hip and knee arthroplasty

TY - JOUR

T1 - Role of preoperative pain, muscle function, and activity level in discharge readiness after fast-track hip and knee arthroplasty

AU - Holm, Bente

AU - Bandholm, Thomas

AU - Lunn, Troels Haxholdt

AU - Husted, Henrik

AU - Aalund, Peter Kloster

AU - Hansen, Torben Bæk

AU - Kehlet, Henrik

PY - 2014/9/1

Y1 - 2014/9/1

N2 - Background and purpose-The concept of fast-track surgery has led to a decline in length of stay after total hip arthroplasty (THA) and total knee arthroplasty (TKA) to about 2C4 days. However, it has been questioned whether this is only achievable in selected patients-or in all patients. We therefore investigated the role of preoperative pain and functional characteristics in discharge readiness and actual LOS in fast-track THA and TKA. Methods-Before surgery, hip pain (THA) or knee pain (TKA), lower-extremity muscle power, functional performance, and physical activity were assessed in a sample of 150 patients and used as independent variables to predict the outcome (dependent variable)-readiness for hospital discharge-for each type of surgery. Discharge readiness was assessed twice daily by blinded assessors. Results-Median discharge readiness and actual length of stay until discharge were both 2 days. Univariate linear regression followed by multiple linear regression revealed that age was the only independent predictor of discharge readiness in THA and TKA, but the standardized coefficients were small (≤ 0.03). Interpretation-These results support the idea that fast-track THA and TKA with a length of stay of about 2-4 days can be achieved for most patients independently of preoperative functional characteristics.

AB - Background and purpose-The concept of fast-track surgery has led to a decline in length of stay after total hip arthroplasty (THA) and total knee arthroplasty (TKA) to about 2C4 days. However, it has been questioned whether this is only achievable in selected patients-or in all patients. We therefore investigated the role of preoperative pain and functional characteristics in discharge readiness and actual LOS in fast-track THA and TKA. Methods-Before surgery, hip pain (THA) or knee pain (TKA), lower-extremity muscle power, functional performance, and physical activity were assessed in a sample of 150 patients and used as independent variables to predict the outcome (dependent variable)-readiness for hospital discharge-for each type of surgery. Discharge readiness was assessed twice daily by blinded assessors. Results-Median discharge readiness and actual length of stay until discharge were both 2 days. Univariate linear regression followed by multiple linear regression revealed that age was the only independent predictor of discharge readiness in THA and TKA, but the standardized coefficients were small (≤ 0.03). Interpretation-These results support the idea that fast-track THA and TKA with a length of stay of about 2-4 days can be achieved for most patients independently of preoperative functional characteristics.

KW - Age Factors

KW - Aged

KW - Arthralgia

KW - Arthroplasty, Replacement, Hip

KW - Arthroplasty, Replacement, Knee

KW - Female

KW - Humans

KW - Knee Joint

KW - Length of Stay

KW - Male

KW - Motor Activity

KW - Muscle, Skeletal

KW - Pain Measurement

KW - Patient Discharge

KW - Preoperative Period

U2 - 10.3109/17453674.2014.934186

DO - 10.3109/17453674.2014.934186

M3 - Journal article

C2 - 24954491

SN - 1745-3674

VL - 85

SP - 488

EP - 492

JO - Acta Orthopaedica

JF - Acta Orthopaedica

IS - 5

ER -