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Singapore Med J ; 60(6): 314-316, 2019 Jun.
Article in English | MEDLINE | ID: mdl-30556092

ABSTRACT

INTRODUCTION: We developed an accelerated clinical pathway involving outpatient surgery for patients undergoing total knee arthroplasty (TKA) who are healthy enough for early discharge. METHODS: Between March 2014 and April 2015, 89 TKAs were performed at a single institution by a single orthopaedic surgeon. 31 patients met the inclusion criteria for the study. All patients received 2 g tranexamic acid and 750 mg cefuroxime sodium intravenously 30 minutes prior to surgery. A multimodal protocol for perioperative pain management was used for all patients. RESULTS: 31 patients (three male, 28 female), with a mean age of 67 (range 49-78) years, who underwent TKA were enrolled in this study. The mean length of hospital stay was 28.7 (range 16-49) hours and mean duration of surgery was 92 (range 75-128) minutes. Combined spinal epidural anaesthesia was performed for 23 (74.2%) patients and general anaesthesia was used in 8 (25.8%) patients. Among the 31 patients, 23 (74.2%) patients were discharged within 23 hours of surgery. CONCLUSION: Early discharge of patients following outpatient surgery for TKA was not associated with any procedure-related complications among the selected patients up to three months postoperatively.


Subject(s)
Ambulatory Surgical Procedures , Arthroplasty, Replacement, Knee , Aged , Ambulatory Surgical Procedures/methods , Arthroplasty, Replacement, Knee/methods , Arthroplasty, Replacement, Knee/rehabilitation , Critical Pathways , Early Ambulation , Female , Humans , Male , Middle Aged , Treatment Outcome
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