What Augmented Physical Activity and Empowerment Can Bring to Patients Receiving Total Knee Replacement: Content, Implementation, and Comparative Effectiveness of a New Function-Tailored Care Pathway in a Routine Care Setting

Background. In the routine setting of the 20-bed orthopaedic ward of a regional hospital in Netherlands, we developed, implemented, and evaluated a new, function-tailored perioperative care pathway for patients receiving total knee replacement (TKR), aimed at faster functional recovery by reduction...

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Bibliographic Details
Published in:BioMed research international 2015-01, Vol.2015 (2015), p.1-8
Main Authors: van Meeteren, Nico L. U., Elings, J., Galindo Garre, F., Bimmel, R., Goldbohm, R. A., van der Sluis, G., Hoogeboom, Thomas J.
Format: Article
Language:English
Subjects:
Aged
Arthritis
Arthroplasty, Replacement, Knee - rehabilitation
Clinical Study
Exercise
Female
Health aspects
Hospitals
Humans
Interdisciplinary aspects
Joint surgery
Length of Stay
Male
Motor Activity
Netherlands
Older people
Osteoarthritis - physiopathology
Osteoarthritis - rehabilitation
Osteoarthritis - surgery
Patient satisfaction
Perioperative Care
Postoperative period
Recovery of Function
Rehabilitation
Surgery
Treatment Outcome
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Summary:Background. In the routine setting of the 20-bed orthopaedic ward of a regional hospital in Netherlands, we developed, implemented, and evaluated a new, function-tailored perioperative care pathway for patients receiving total knee replacement (TKR), aimed at faster functional recovery by reduction of inactivity and stimulation of self-efficacy of the patients. Methods. To assess effectiveness, we compared, using prospectively collected data from medical files, patient groups before n = 127 and after n = 108 introduction of the new care pathway with respect to time to recovery of physical functioning during hospitalisation (five milestones), length of hospital stay (LoS), referrals to an inpatient rehabilitation facility, and readmissions. Multivariable regression was used to adjust results for differences between the two groups in preoperatively assessed risk factors for delayed recovery. Results. Comparison of patient groups before n = 127 and after n = 108 introduction of the tailored care pathway showed that the tailored rehabilitation pathway decreased the time to recovery of physical functioning (from 4.5 to 4.1 days, P < 0.05 ), the mean LoS (from 5.2 days to 4.2 days, P < 0.01 ). Conclusion. We demonstrated that the introduction of a function-tailored care pathway shortens the hospital stay and accelerates the recovery of physical functioning.
ISSN:2314-6133
2314-6141
DOI:10.1155/2015/745864