Safety of Total Knee Replacement Surgery Before and After the Implementation of Enhanced Recovery Program

Groupe Hospitalier de la Rochelle Ré Aunis

Status: Completed

Conditions: Arthroplasty Complications

Treatments: Procedure: Enhanced recovery program

Study type: Observational

Funder types: Other

Identifiers

NCT05028426

2018/P01/266

Details and patient eligibility

About

The objectives are to describe the transition from traditional care to an enhanced recovery program for the management of total knee arthroplasty, and to evaluate the effect on patient outcomes.

Full description

Enhanced recovery programs are an organizational evolution in surgical patient management, in which the patient becomes an actor of his or her own recovery. This multimodal approach aims at optimizing patient physiological and psychological states across preoperative, intraoperative and postoperative domains of care.

At la Rochelle hospital, the decision to take the step happened at the end of 2016. It was proposed by a young surgeon that have been trained on this new approach during his studies and who convinced the head of the surgery department of the benefits for the patients, the healthcare workers, and the institution. The transition took place in two stages, first operative and postoperative techniques were modified, and then preoperative education and counselling were added.

Enrollment: 455 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients operated on for posterior-stabilized total knee arthroplasty between January 2015 and December 2018
• unilateral arthroplasty
• a known address for mailing the study information letter

Exclusion criteria

• revision arthroplasty
• patients who refused to the use of their data

Trial design

455 participants in 3 patient groups

Traditional method of care

Description:

Patients managed according to the traditional care protocol without an enhanced recovery program

Some elements of a fast-track program

Description:

operative and postoperative techniques were modified according to a fast-track program

Treatment:

Procedure: Enhanced recovery program

Full enhanced recovery program

Description:

Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added)

Treatment:

Procedure: Enhanced recovery program