Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery: a randomized controlled pilot study with 5-year follow-up

Bas L. Fransen, Marco J.M. Hoozemans, Kirsten D.S. Argelo, Lucien C.M. Keijser, Bart J. Burger

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Introduction: Fast-track protocols (FP) are used more and more to optimize results after total knee arthroplasty (TKA). Many studies evaluating FP in TKA concentrate on clinical outcome and medium to long-term results. Since discharge from hospital after TKA is achieved increasingly quicker worldwide using FP in an increasingly younger and active patient population, the effects of FP on functional outcome in the first days after TKA become more important. The purpose of the current study was to compare FP with a regular joint care protocol (RP), with an emphasis on the first 7 days after surgery. Materials and methods: A non-blinded randomized controlled clinical pilot study was performed with 25 patients assigned to a FP group and 25 patients assigned to a RP group. Primary outcome was functional outcome, clinical outcome, pain, and complications for each day in the first week after surgery. Patients were followed up to 5 years after surgery. Results: Significantly lower VAS scores for knee pain, faster Timed-Up and Go test times and more mobility on functional tests were seen on several days in the first week in the FP group compared to the RP group. Few other significant differences were found at 2, 6 weeks, and no significant differences were found at 12 weeks and 1, 2 and 5 years after surgery. Conclusions: Fast-track protocol for primary TKA showed significantly lower knee pain scores and improved functional outcome in the first 7 days after TKA compared to a regular protocol.

Original languageEnglish
Pages (from-to)1305-1316
Number of pages12
JournalArchives of Orthopaedic and Trauma Surgery
Volume138
Issue number9
Early online date19 Jul 2018
DOIs
Publication statusPublished - Sep 2018

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Knee Replacement Arthroplasties
Pain
Knee
Joints
Population

Keywords

  • Fast-track protocol
  • Functional outcome
  • Total knee arthroplasty

Cite this

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title = "Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery: a randomized controlled pilot study with 5-year follow-up",
abstract = "Introduction: Fast-track protocols (FP) are used more and more to optimize results after total knee arthroplasty (TKA). Many studies evaluating FP in TKA concentrate on clinical outcome and medium to long-term results. Since discharge from hospital after TKA is achieved increasingly quicker worldwide using FP in an increasingly younger and active patient population, the effects of FP on functional outcome in the first days after TKA become more important. The purpose of the current study was to compare FP with a regular joint care protocol (RP), with an emphasis on the first 7 days after surgery. Materials and methods: A non-blinded randomized controlled clinical pilot study was performed with 25 patients assigned to a FP group and 25 patients assigned to a RP group. Primary outcome was functional outcome, clinical outcome, pain, and complications for each day in the first week after surgery. Patients were followed up to 5 years after surgery. Results: Significantly lower VAS scores for knee pain, faster Timed-Up and Go test times and more mobility on functional tests were seen on several days in the first week in the FP group compared to the RP group. Few other significant differences were found at 2, 6 weeks, and no significant differences were found at 12 weeks and 1, 2 and 5 years after surgery. Conclusions: Fast-track protocol for primary TKA showed significantly lower knee pain scores and improved functional outcome in the first 7 days after TKA compared to a regular protocol.",
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Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery : a randomized controlled pilot study with 5-year follow-up. / Fransen, Bas L.; Hoozemans, Marco J.M.; Argelo, Kirsten D.S.; Keijser, Lucien C.M.; Burger, Bart J.

In: Archives of Orthopaedic and Trauma Surgery, Vol. 138, No. 9, 09.2018, p. 1305-1316.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery

T2 - a randomized controlled pilot study with 5-year follow-up

AU - Fransen, Bas L.

AU - Hoozemans, Marco J.M.

AU - Argelo, Kirsten D.S.

AU - Keijser, Lucien C.M.

AU - Burger, Bart J.

PY - 2018/9

Y1 - 2018/9

N2 - Introduction: Fast-track protocols (FP) are used more and more to optimize results after total knee arthroplasty (TKA). Many studies evaluating FP in TKA concentrate on clinical outcome and medium to long-term results. Since discharge from hospital after TKA is achieved increasingly quicker worldwide using FP in an increasingly younger and active patient population, the effects of FP on functional outcome in the first days after TKA become more important. The purpose of the current study was to compare FP with a regular joint care protocol (RP), with an emphasis on the first 7 days after surgery. Materials and methods: A non-blinded randomized controlled clinical pilot study was performed with 25 patients assigned to a FP group and 25 patients assigned to a RP group. Primary outcome was functional outcome, clinical outcome, pain, and complications for each day in the first week after surgery. Patients were followed up to 5 years after surgery. Results: Significantly lower VAS scores for knee pain, faster Timed-Up and Go test times and more mobility on functional tests were seen on several days in the first week in the FP group compared to the RP group. Few other significant differences were found at 2, 6 weeks, and no significant differences were found at 12 weeks and 1, 2 and 5 years after surgery. Conclusions: Fast-track protocol for primary TKA showed significantly lower knee pain scores and improved functional outcome in the first 7 days after TKA compared to a regular protocol.

AB - Introduction: Fast-track protocols (FP) are used more and more to optimize results after total knee arthroplasty (TKA). Many studies evaluating FP in TKA concentrate on clinical outcome and medium to long-term results. Since discharge from hospital after TKA is achieved increasingly quicker worldwide using FP in an increasingly younger and active patient population, the effects of FP on functional outcome in the first days after TKA become more important. The purpose of the current study was to compare FP with a regular joint care protocol (RP), with an emphasis on the first 7 days after surgery. Materials and methods: A non-blinded randomized controlled clinical pilot study was performed with 25 patients assigned to a FP group and 25 patients assigned to a RP group. Primary outcome was functional outcome, clinical outcome, pain, and complications for each day in the first week after surgery. Patients were followed up to 5 years after surgery. Results: Significantly lower VAS scores for knee pain, faster Timed-Up and Go test times and more mobility on functional tests were seen on several days in the first week in the FP group compared to the RP group. Few other significant differences were found at 2, 6 weeks, and no significant differences were found at 12 weeks and 1, 2 and 5 years after surgery. Conclusions: Fast-track protocol for primary TKA showed significantly lower knee pain scores and improved functional outcome in the first 7 days after TKA compared to a regular protocol.

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