DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 110
Daycase unicompartmental knee replacement surgery
Anders Lamberg, Claus Fink Jepsen, Frank Madsen, Anders Odgaard
Dept. of Orthopedic surgery, University Hospital of Aarhus
Background: Today’s standard of care in knee arthroplasty surgery is
hospital admission for 2-4 days.
Purpose: The purpose of this paper is to describe our standard of care in
unicompartmental knee replacement surgery (UKR) , performed as daycase
surgery.
Methods: We have offered UKR as the standard treatment for arthritis
of the medial tibiofemoral joint space since 2005. In 2007 we initialized
a protocol performing UKR as daycase surgery. All patients are offered
an extensive information program including instruction by doctors, nurses
and physiotherapists. Before discharge from the hospital, the patient
is evaluated according to the protocol by a trained nurse. A nurse conducts
a 4-6 days outpatient visit, monitoring swelling, pain, nausea and
oozing. After 6 to 8 weeks the patient is evaluated by a physiotherapist.
We collected data on length of stay for all patients from 2005 to 2010.
We describe the 4-6 days results of a cohort of 35 consecutive patients
who had a UKR in 2010.
Findings: We have registered 198 medial UKR since starting the daycase
protocol. 95 of the 198 patients were discharged on the day of surgery.
In our 35 patient cohort, 23 of 24 patients evaluated their surgery
and 4-6 days of rehabilitation as good or excellent; 1/24 neither good nor
bad; 11 missing. 31/35 exercised as recommended; 30/35 satisfactory
pain treatment; VAS at rest: mean 1,5 (SD 2,0), VAS during activity:
mean 4,3 (SD 2,3). 27/35 had no nausea the last 24 hours, 28/35 did not
have problems eating. 11/35 reported constipation or slow bowel function.
4/35 had minor oozing from the wound; no patient had any sign of
infection.
Conclusion: We state that daycase UKR surgery is a safe and satisfactory
procedure, as performed by our protocol.
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