Overlapping surgery in arthroplasty - a systematic review and meta-analysis.
Orthop Traumatol Surg Res
; 109(4): 103299, 2023 06.
Article
in En
| MEDLINE
| ID: mdl-35472455
ABSTRACT
BACKGROUND:
Planned overlapping surgery can improve efficiency, reduce costs and help manage long waiting lists; yet, this practice has been questioned due to patient safety concerns. A systematic review and meta-analysis were performed to answer the question (1) are there any differences in the risk of postoperative adverse outcomes; and (2) are there any differences in length of stay or length of surgery, in elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) performed either as non-overlapping surgery (NOS) or overlapping surgery (OS). PATIENTS ANDMETHODS:
A systematic search of literature in the databases of MEDLINE, PubMed, Embase and Cochrane from dates of inception was performed. All studies published in English were included. Risk of Bias in Non-randomised Studies-of Interventions (ROBINS-I) and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework were utilised. Relative risk (RR) was used for dichotomous outcomes, while mean difference (MD) was used for continuous variables, with 95% confidence intervals. Alpha was set at 0.05.RESULTS:
A total of nine studies with 120,625 patients were included for analyses. There were no statistically significant differences for overall rates of postoperative complications, dislocations, fractures, infections, readmissions or revision surgery nor with length of stay or length of surgery (p>0.05). Patient characteristics between groups were similar (p>0.05).DISCUSSION:
There were no differences in postoperative adverse outcomes for elective orthopaedic THA and TKA performed as NOS when compared to OS. Operating schedules for OS in elective lower limb arthroplasty appear to be safe, given appropriate patient selection processes and may be a useful method to improve hospital efficiency. Informed consent and preoperative patient education should remain paramount. LEVEL OF EVIDENCE IV.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Arthroplasty, Replacement, Hip
/
Arthroplasty, Replacement, Knee
Type of study:
Clinical_trials
/
Etiology_studies
/
Guideline
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
Orthop Traumatol Surg Res
Year:
2023
Document type:
Article