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 importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

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: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

Previous evidence of water on mars now identified as grainflows

21.11.2017 | Physics and Astronomy

NASA's James Webb Space Telescope completes final cryogenic testing

21.11.2017 | Physics and Astronomy

New catalyst controls activation of a carbon-hydrogen bond

21.11.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>