Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Ninety-six percent of minimally invasive knee replacement patients leave same day, no complication


’Pre-surgical’ team approach gets patients ready to leave same day

Orthopedic surgeons at Rush University Medical Center found that 96 percent of patients who had minimally invasive total knee replacement surgery were able to go home the same day, without complications-many walking out unassisted or with a cane. These results were published in the October issue of the Journal of Arthroplasty.

Lead author surgeon Richard A. Berger says it’s not just the surgeon’s skills and techniques that help patients avoid a hospital stay.

"It’s a comprehensive management pathway helps the patient avoid an overnight stay. It’s optimal sequencing and timing of interventions by the nursing, physical therapy, anesthesia surgical team; it’s a team approach of equally weighted preoperative, intraoperative, and postoperative care."

Patients meet with the physical therapist and nurse prior to surgery. "The nurse time is invaluable to patient before going into surgery," says Berger. "They attend a class led by with a nurse where potential surgical complications and postoperative care are discussed.

Patients spend an hour learning about the surgery, asking questions about pain, recovery and surgery. We reassure patients that their pain will be controlled, that they will be carefully monitored for the occurrence of complications or delayed recovery due to early discharge, and explain how will be able to move around independently after surgery.

After class with the nurse, patients have a physical therapy session for instruction in gait training with crutches and a cane. An internist also evaluates patients as part of our hospital’s policy. Lastly, the hospital discharge planner calls the patient at home before surgery to make sure all someone can take him or her home after surgery."

The 50 study patients (20 female, 30 males) had surgery between August 2003 and August 2004. The average age was 68 years old, average weight of 203 lbs. with a body mass index of 29.2. Forty-eight of the patients had osteoarthritis. Each patient was the first surgical case of the day.

Berger, who pioneered and perfected minimally invasive outpatient surgery, explains his technique for total knee arthroscopy (TKA) does not cut the quadriceps muscle and quadriceps tendon.

"The only incision is from the joint line to the superior pole of the patella. The quadriceps tendon is not cut or split. The knee is not dislocated; instead, in situ cuts are made. The patient is out of surgery in less than two hours."

After surgery, patients see an occupational and physical therapist. To be released, patients must be able to independently get in and out of bed, rise from a chair, walk 100 feet, and walk up and down a full flight of stairs. Patients are then asked if they feel comfortable and would like to go home and are released with pain medication.

Patients receive home physical therapy until they can drive; then, outpatient physical therapy is started. Patients were evaluated clinically and radiographically in the office at one week, two weeks, six weeks, and three months.

Berger says this study demonstrates that, in these selected patients, "outpatient TKA was safe with no short-term readmission or complications related to early discharge. New clinical pathways, including improvements in anesthetic techniques, postoperative pain management, and rehabilitation protocols, will make performing outpatient TKA a realistic goal. This comprehensive pathway may make it possible for this minimally invasive knee surgery to be done as an outpatient in specialized surgicenters in the future."

Mary Ann Schultz | EurekAlert!
Further information:

More articles from Studies and Analyses:

nachricht Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung

nachricht High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

Im Focus: Ultra-thin ferroelectric material for next-generation electronics

'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.

Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Resolving the mystery of preeclampsia

21.10.2016 | Health and Medicine

Stanford researchers create new special-purpose computer that may someday save us billions

21.10.2016 | Information Technology

From ancient fossils to future cars

21.10.2016 | Materials Sciences

More VideoLinks >>>