Abstract:
BACKGROUND:In Denmark, approximately 12,000 hip and knee arthroplasties were performed in 2006, and the hospital costs were close to US$ 110,000,000. In a randomized clinical trial, we have recently demonstrated the efficacy of accelerated perioperative care and rehabilitation intervention after hip and knee arthroplasty compared to current intervention under ideal circumstances. We do not, however, know whether these results could be reached under usual circumstances of healthcare practice. We therefore investigated whether length of stay after implementation of accelerated perioperative care and rehabilitation after hip and knee arthroplasty could be reduced in a normal healthcare setting, and how the achieved results matched those observed during the randomized clinical trial. METHODS:An effectiveness study as a before-after trial was undertaken in which all elective primary total hip and total knee arthroplasty patients were divided into a before-implementation group receiving the current perioperative procedure, and an after-implementation group receiving the new accelerated perioperative care and rehabilitation procedures as provided by a new multi-disciplinary organization. We used the Breakthrough Series Collaborative Model for implementation. The primary outcome measure was in hospital length of stay (LOS), and the secondary outcome measure was adverse effects within 3 months postoperatively. RESULTS:We included a total of 247 patients. Mean LOS was significantly (P < 0.001) reduced by 4.4 (95% CI 3.8-5.0) days after implementation of the accelerated intervention, from 8.8 (SD 3.0) days before implementation to 4.3 (SD 1.8) days after implementation. No significant differences in adverse effects were observed. LOS in this effectiveness study was significantly lower than LOS reported in the efficacy study. CONCLUSION:Accelerated perioperative care and rehabilitation intervention after hip and knee arthroplasty was successfully and effectively implemented. Results obtained during usual hospital circumstances matched the results achieved under ideal circumstances in this group of patients.
journal_name
BMC Musculoskelet Disordjournal_title
BMC musculoskeletal disordersauthors
Larsen K,Hvass KE,Hansen TB,Thomsen PB,Søballe Kdoi
10.1186/1471-2474-9-59subject
Has Abstractpub_date
2008-04-28 00:00:00pages
59issn
1471-2474pii
1471-2474-9-59journal_volume
9pub_type
杂志文章abstract:BACKGROUND:Our study aim was to compare allogeneic cancellous bone (ACB) and synthetic or highly-processed xenogeneic bone substitutes (SBS) in the treatment of skeletal defects in orthopedic surgery. METHODS:232 patients treated for bony lesions with ACB (n = 116) or SBS (n = 116) within a 10-year time period were in...
journal_title:BMC musculoskeletal disorders
pub_type: 临床试验,杂志文章
doi:10.1186/s12891-016-0930-1
更新日期:2016-02-13 00:00:00
abstract:BACKGROUND:To identify the optimal viewing angles for every proximal screw in PHILOS plate-fixed proximal humeral fractures. METHODS:Three fresh-frozen human cadaveric bodies with six intact shoulders were studied. All three bodies were put in the beach chair position and PHILOS plates were placed on the proximal hume...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-018-2247-8
更新日期:2018-09-07 00:00:00
abstract:BACKGROUND:This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. METHODS:A systematic computer sear...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,评审
doi:10.1186/s12891-020-03241-1
更新日期:2020-04-10 00:00:00
abstract:BACKGROUND:Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the energy transferred during trauma has its influence on the risk on associated ipsilateral upper limb injuries. However, relationships between Mason classification, mechanism of injury, and associated injuries have ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-015-0603-5
更新日期:2015-06-05 00:00:00
abstract:BACKGROUND:Patients who undergo lumbar disc surgery for herniated discs, are advocated two different postoperative management strategies: a watchful waiting policy, or referral for rehabilitation immediately after discharge from the hospital. A direct comparison of the effectiveness and cost-effectiveness of these two ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2474-14-124
更新日期:2013-04-05 00:00:00
abstract:BACKGROUND:Many patients with cervical radiculopathy experience stenosis of the neural foramens due to cumulative osteophyte or uncovertebral joint hypertrophy. For cervical foraminal stenosis, complete uncinate process resection (UPR) is often conducted concurrently with anterior discectomy and fusion (ACDF). The aim ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03443-7
更新日期:2020-07-06 00:00:00
abstract:BACKGROUND:Whether the increase in vascular disease prevalence and mortality in OA populations is a result of co-occurrence of cardiovascular disease and OA, which are both common in the older population, is due to OA treatments or to the common association with reduced physical activity and/or obesity is unclear. One ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-13-255
更新日期:2012-12-20 00:00:00
abstract:BACKGROUND:The incidence of shoulder arthroplasties is reportedly increasing and the types of arthroplasty are changing. The purpose of this study was to investigate the incidence of primary shoulder arthroplasty in Finland. METHODS:We analyzed nationwide data from the Finnish Arthroplasty Register (FAR) and the Finni...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-018-2150-3
更新日期:2018-07-21 00:00:00
abstract:BACKGROUND:Hip fractures constitute an economic burden on healthcare resources. Most persons with a hip fracture undergo surgery. As morbidity and mortality rates are high, perioperative care leaves room for improvement. Improvement can be achieved if it is organized in comprehensive care pathways, but the effectivenes...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2474-14-291
更新日期:2013-10-12 00:00:00
abstract:BACKGROUND:Different substances are combined to compensate for each other's drawbacks and create an appropriate biomaterial. A novel Polyvinyl alcohol (PVA)/chitosan (CS) porous hydrogel was designed and applied to the treatment of osteochondral defects. METHODS:Hydrogels of various PVA/CS ratios were tested for physi...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2644-7
更新日期:2019-05-29 00:00:00
abstract:BACKGROUND:Range of abduction often decreases during Legg-Calvé-Perthes Disease (LCPD) disease. However, a good range of abduction is required during the course of LCPD, especially when containment surgery should be performed. This study aimed to investigate how many patients registered in the Swedish Pediatric Orthope...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03705-4
更新日期:2020-11-05 00:00:00
abstract:BACKGROUND:Changes to the integrity of the acromioclavicular (AC) joint impact scapulothoracic and clavicular kinematics. AC ligaments provide anterior-posterior stability, while the coracoclavicular (CC) ligaments provide superior-inferior stability and a restraint to scapular internal rotation. The purpose of this ca...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-1330-2
更新日期:2016-11-17 00:00:00
abstract:BACKGROUND:Septic arthritis of the elbow joint is a rare condition. Limited data is available on infections of the elbow joint following trauma or prior surgery on this joint. The aim of this study was to describe the etiology, comorbidities, bacterial spectrum and therapy of secondary purulent elbow infections. METHO...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-3046-6
更新日期:2020-01-18 00:00:00
abstract:BACKGROUND:Primary patellofemoral dislocations are common. In most patients, non-operative management produces satisfactory outcome. If the dislocation recurs after a trial of rehabilitation, operative intervention is considered, with the aim of restoring the soft tissue anatomy to normal. Ninety four percent of patien...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-8-22
更新日期:2007-02-28 00:00:00
abstract:BACKGROUND:Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have attempted to apply the Les...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-11-166
更新日期:2010-07-21 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the clinical and radiographic outcomes of hip resurfacing patients and compare them to standard primary total hip arthroplasty procedures performed during the same period of time. METHODS:One hundred and fourteen consecutive men who had a mean age of 50 years (range...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-14-161
更新日期:2013-05-08 00:00:00
abstract:BACKGROUND:Risk factors for venous thromboembolism (VTE) of total joint arthroplasty (TJA) have been examined by many studies. A comprehensive systematic review of recent findings of high evidence level in this topic is needed. METHODS:We conducted a PubMed search for papers published between 2003 and 2013 that provid...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,评审
doi:10.1186/s12891-015-0470-0
更新日期:2015-02-10 00:00:00
abstract:BACKGROUND:The best surgical modality for treating chronic periprosthetic shoulder infections has not been established, with a lack of randomised comparative studies. This systematic review compares the infection eradication rate and functional outcomes after single- or two-stage shoulder exchange arthroplasty, to perm...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章,评审
doi:10.1186/s12891-016-0901-6
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The periprosthetic joint infection (PJI) is a severe complication in the field of arthroplasty. Despite the rising number of primary joint replacements, no unified therapeutic standard has been established for the treatment of PJI yet. METHODS:A survey on the principles of treatment of PJI in Germany was co...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03670-y
更新日期:2020-10-19 00:00:00
abstract:ABTSRACT:BACKGROUND: Numerous comparative studies of surgical procedures have focused on clinical and radiographical outcomes, as well as the effect of bone fragility on the outcome of spinal surgery; however, insights concerning a risk of mortality or morbidity have been limited. Additionally, the effect of surgical t...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-020-03564-z
更新日期:2020-08-10 00:00:00
abstract:BACKGROUND:Sensory information from mechanoreceptors in the skin, muscles, tendons, and joint structures plays an important role in joint stability. A joint injury can lead to disruption of the sensory system, which can be measured by proprioceptive acuity. When evaluating proprioception, assessment tools need to be re...
journal_title:BMC musculoskeletal disorders
pub_type: 临床试验,杂志文章
doi:10.1186/1471-2474-8-57
更新日期:2007-07-03 00:00:00
abstract:BACKGROUND:LBP is a common and serious problem affecting vast populations of the world. However, only few studies on LBP in sub-Saharan Africa have been conducted. Studies report that LBP and pelvic angle are interrelated, and African residents have a high pelvic tilt. The strategy to prevent LBP should focus on activi...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2953-x
更新日期:2019-12-04 00:00:00
abstract:BACKGROUND:This study assessed the incidence and excess mortality of hip fractures among inpatients aged 20-40 years in a nationwide population database in Taiwan. METHODS:Subjects were selected from Taiwan's National Health Insurance Research Database for the period 2001-2008 and were followed up until the end of 201...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-016-1166-9
更新日期:2016-08-05 00:00:00
abstract:BACKGROUND:Although the pathogenesis of adolescent idiopathic scoliosis (AIS) remains controversial, genetic factors are thought to play key roles in the development of AIS. In a recent genome-wide association study, a polymorphism in the interleukin-17 receptor C (IL-17RC) gene was reported to be associated with the s...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-13-181
更新日期:2012-09-21 00:00:00
abstract:BACKGROUND:The main aim of the study was to investigate the relationship between persistent disease activity and radiographic progression of joint damage in early rheumatoid arthritis (ERA). METHODS:Forty-eight patients with active ERA was assessed every 3 months for disease activity for 3 years. Radiographic damage w...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-12-120
更新日期:2011-05-30 00:00:00
abstract:BACKGROUND:Patients with whiplash-associated disorders (WAD) have a generally favourable prognosis, yet some develop longstanding pain and disability. Predicting who will recover from WAD shortly after a traffic collision is very challenging for health care providers such as physical therapists. Therefore, we aimed to ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-13-264
更新日期:2012-12-29 00:00:00
abstract:BACKGROUND:In this study, we evaluated the changes which occurred in the epiligament, an enveloping tissue of the ligament, during the ligament healing. We assessed the association of epiligament elements that could be involved in ligament healing. METHODS:Thirty-two 8-month old male Wistar rats were used in this stud...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/1471-2474-11-117
更新日期:2010-06-13 00:00:00
abstract:BACKGROUND:Local antibiotic application has been widely used in orthopedic surgery. The dose-related toxicity of antibiotics towards periosteal tissues and resulting effects on osteogenic expression are yet to be studied. METHODS:Periosteal cells harvested from the medial tibia of New Zealand White rabbits were used. ...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-019-2705-y
更新日期:2019-07-26 00:00:00
abstract:BACKGROUND:Calcaneal apophysitis is a common clinical entity affecting children and adolescents. It is also known as Sever's disease. Heel pain without a recent trauma is the primary manifestation. There are limited studies on the incidence of this disease. In this study, we aimed to report the regional incidence in Is...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-018-2184-6
更新日期:2018-07-27 00:00:00
abstract:BACKGROUND:Isolated greater trochanter (GT) fractures are relatively rare and few studies have assessed the appropriate diagnostic and therapeutic strategies for these fractures. When initial plain radiographs show an isolated GT fracture, underestimation of occult intertrochanteric extension may result in displacement...
journal_title:BMC musculoskeletal disorders
pub_type: 杂志文章
doi:10.1186/s12891-018-2193-5
更新日期:2018-07-25 00:00:00