DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20185327

Comparison of functional outcome at three month follow up using knee society score in patients undergoing total knee replacement by ERP and non ERP

Sawan Kumar Pawar, Susheel Soni, Shreedhar Archik

Abstract


Background: Comparison of functional outcome at three month follow up using knee society score in patients undergoing total knee replacement by ERP and Non ERP.

Methods: In this prospective study of 29 patients in group (II) who underwent total knee arthroplasty using Enhanced recovery protocol and compared with 29 patients in control group (I) whose data was obtained from hospital database in Lilavati Hospital & Research Centre, Mumbai.

Results: The majority of the patients were from the age group of 61-70 years in both group I & II. There was female predominance in our study. The mean length of stay for group I was 5.69 days and for group II 3.28 days. The average knee clinical score in group I was pre op 33.52 which improved to an average post-op score of 82.62 at 3 months and for group II it improved from 34.21 to 84.66 at 3 months. The average pre-op knee functional score was 43.28 which improved to an average post-op score of 85.00 at 3 months in study group II. The average pre-op Knee Society Score was 77.14 which improved to an average post-op score of 169.66 at 3 months follow up for group II.

Conclusions: The results of the present study showed that patients who underwent TKA using ERP protocol has reduced length of stay in hospital, significantly improved KSS proving TKA as an effective procedure that is associated with substantial functional improvement.


Keywords


ERP, Non ERP, Total knee arthroplasty, Knee functional score, Knee society score, Knee clinical score

Full Text:

PDF

References


KaFG WN. Kelley’s Textbook of Rheumatology. 8th ed. Philadelphia: Saunders Elsevier; 2009.

Buckwalter JA, Mankin HJ. Articular cartilage: degeneration and osteoarthritis, repair, regeneration, and transplantation. Instructional course lectures. 1998;47:487-504.

Blagojevic M, Jinks C, Jeffery A, Jordan KP. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society. 2010;18(1):24-33.

Pachore JA, Vaidya SV, Thakkar CJ, Bhalodia HK, Wakankar HM. ISHKS joint registry: A preliminary report. Indian J Orthop. 2013;47(5):505-9.

Bae DK, Song SJ, Park MJ, Eoh JH, Song JH, Park CH. Twenty-year survival analysis in total knee arthroplasty by a single surgeon. J Arthroplasty. 2012;27(7):1297-304.

Nanavati AJ, Prabhakar S. Fast-track surgery: Toward comprehensive peri-operative care. Anesthesia, essays and researches. 2014;8(2):127-33.

Larsen K, Hansen TB, Thomsen PB, Christiansen T, Soballe K. Cost-effectiveness of accelerated perioperative care and rehabilitation after total hip and knee arthroplasty. J Bone Joint Surg Am Vol. 2009;91(4):761-72.

Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Annals of surgery. 2008;248(2):189-98.

Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H. Why still in hospital after fast-track hip and knee arthroplasty? Acta orthopaedica. 2011;82(6):679-84.

Husted H, Jensen CM, Solgaard S, Kehlet H. Reduced length of stay following hip and knee arthro plasty in Denmark 2000-2009: from research to implementation. Arch Orthop Trauma Surg. 2012;132(1):101-4.

Nanavati AJ, Nagral S, Prabhakar S. Fast-track surgery in India. National Med J India. 2014;27(2):79-83.

Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Related Res. 1989;248:13-4.

Starks I, Wainwright T, Middleton R. Local Anaesthetic Infiltration in Joint Replacement Surgery: What Is Its Role in Enhanced Recovery? ISRN Anesthesiology. 2011;2011.

Rostlund T, Kehlet H. High-dose local infiltration analgesia after hip and knee replacement--what is it, why does it work, and what are the future challenges? Acta Orthop. 2007;78(2):159-61.

Dwyer AJ, Thomas W, Humphry S, Porter P. Enhanced recovery programme for total knee replacement to reduce the length of hospital stay. J Orthop Surg. 2014;22(2):150-4.

Zanasi S. Innovations in total knee replacement: new trends in operative treatment and changes in peri-operative management. European Orthop Traumatol. 2011;2(1-2):21-31.

Dieppe P, Basler H, Chard J, Croft P, Dixon J, Hurley M, et al. Knee replacement surgery for osteoarthritis: effectiveness, practice variations, indications and possible determinants of utilization. Rheumatology. 1999;38(1):73-83.

Callahan CM, Drake BG, Heck DA, Dittus RS. Patient outcomes following tricompartmental total knee replacement: a meta-analysis. JAMA. 1994;271(17):1349-57.

Koksal I, Tahta M, Simsek ME, Dogan M, Bozkurt M. Efficacy of rapid recovery protocol for total knee arthroplasty: a retrospective study. Acta orthopaedica et traumatologica turcica. 2015;49(4):382-6.

Dhawan R, Rajgor H, Yarlagadda R, John J, Graham NM. Enhanced recovery protocol and hidden blood loss in patients undergoing total knee arthroplasty. Indian J orthop. 2017;51(2):182-6.

den Hertog A, Gliesche K, Timm J, Muhlbauer B, Zebrowski S. Pathway-controlled fast-track rehabilitation after total knee arthroplasty: a randomized prospective clinical study evaluating the recovery pattern, drug consumption, and length of stay. Arch Orthop Trauma Surg. 2012;132(8):1153-63.

Jørgensen C, Kehlet H, Soeballe K, Hansen TB, Laursen MB, Hansen LT, et al. Role of patient characteristics for fast-track hip and knee arthroplasty. British J Aanaesthesia. 2013:aes505.

McDonald DA, Siegmeth R, Deakin AH, Kinninmonth AW, Scott NB. An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom--follow up at one year. Knee. 2012;19(5):525-9.