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

20.12.2005


’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:
http://www.rush.edu

More articles from Studies and Analyses:

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

nachricht Europe’s Demographic Future. Where the Regions Are Heading after a Decade of Crises
10.08.2017 | Berlin-Institut für Bevölkerung und Entwicklung

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: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

Im Focus: Quantum Sensors Decipher Magnetic Ordering in a New Semiconducting Material

For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.

Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...

Im Focus: Fast, convenient & standardized: New lab innovation for automated tissue engineering & drug

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.

MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Comet or asteroid? Hubble discovers that a unique object is a binary

21.09.2017 | Physics and Astronomy

Cnidarians remotely control bacteria

21.09.2017 | Life Sciences

Monitoring the heart's mitochondria to predict cardiac arrest?

21.09.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>