Abstract:
BACKGROUND AND PURPOSE:Length of stay (LOS) following total hip and knee arthroplasty (THA and TKA) has been reduced to about 3 days in fast-track setups with functional discharge criteria. Earlier studies have identified patient characteristics predicting LOS, but little is known about specific reasons for being hospitalized following fast-track THA and TKA. PATIENTS AND METHODS:To determine clinical and logistical factors that keep patients in hospital for the first postoperative 24-72 hours, we performed a cohort study of consecutive, unselected patients undergoing unilateral primary THA (n = 98) or TKA (n = 109). Median length of stay was 2 days. Patients were operated with spinal anesthesia and received multimodal analgesia with paracetamol, a COX-2 inhibitor, and gabapentin-with opioid only on request. Fulfillment of functional discharge criteria was assessed twice daily and specified reasons for not allowing discharge were registered. RESULTS:Pain, dizziness, and general weakness were the main clinical reasons for being hospitalized at 24 and 48 hours postoperatively while nausea, vomiting, confusion, and sedation delayed discharge to a minimal extent. Waiting for blood transfusion (when needed), for start of physiotherapy, and for postoperative radiographic examination delayed discharge in one fifth of the patients. INTERPRETATION:Future efforts to enhance recovery and reduce length of stay after THA and TKA should focus on analgesia, prevention of orthostatism, and rapid recovery of muscle function.
journal_name
Acta Orthopjournal_title
Acta orthopaedicaauthors
Husted H,Lunn TH,Troelsen A,Gaarn-Larsen L,Kristensen BB,Kehlet Hdoi
10.3109/17453674.2011.636682subject
Has Abstractpub_date
2011-12-01 00:00:00pages
679-84issue
6eissn
1745-3674issn
1745-3682journal_volume
82pub_type
杂志文章abstract:BACKGROUND:Aseptic loosening is the major cause of implant failure. In cemented hip arthroplasty, failure of the acetabular side is mainly due to lysis caused by wear particles. By using an implant with low wear characteristics and by enhancing acetabular fixation using an uncemented implant, we aimed to reduce acetabu...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710014103
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The number of periprosthetic fractures following total hip arthroplasty (THA) is increasing. There is, however, limited data on the functional outcome following these injuries. We analyzed functional outcome for revision THA following periprosthetic fracture, and compared this to the outcome of e...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710015463
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abstract:BACKGROUND AND PURPOSE:Internal fixation (IF) in femoral neck fractures has high reoperation rates and some predictors of failure are known, such as age, quality of reduction, and implant positioning. Finding new predictors of failure is an ongoing process, and in this study we evaluated the importance of low bone mine...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2013.875360
更新日期:2014-02-01 00:00:00
abstract::Background and purpose - Total ankle replacement (TAR) is gaining popularity for treatment of end-stage ankle arthritis. Large patient-centered outcome studies are, however, few. Here, we report data from the Swedish Ankle Registry. Patients and methods - We examined outcomes after primary TAR in patients from the Swe...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1366405
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:(18)F-FDG PET is a widely used tool for molecular imaging of oncological, cardiovascular, and neurological disorders. We evaluated (18)F-FDG microPET as an implant osteomyelitis imaging tool using a Staphylococcus aureus-induced peroperative implant infection in rabbits. METHODS:Intramedullary t...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.900894
更新日期:2014-06-01 00:00:00
abstract::Background and purpose - The long-term outcome of pin-fixed supracondylar humerus fractures (SCHF) in children is not well known. We assessed the 7- to 12-year outcome in 168 children. Patients and methods - During 2002-2006, 210 domestic children (age 7 (1-14) years) with SCHF (Gartland III 79%, Gartland II 19%, and ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2018.1438765
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Problems during knee extension, due to kinematic alterations, are not uncommon after total knee arthroplasty. Hinged prostheses provide higher stability than non-hinged designs and may minimize these alterations. Thus, in this in vitro study we investigated the quadriceps force required to extend...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710014734
更新日期:2008-02-01 00:00:00
abstract::- Knee pathologies including focal cartilage injuries, osteoarthritis (OA), and ligament injuries are common. The poor regeneration and healing potential of cartilage has led to the search for other treatment modalities with improved healing capacity. Furthermore, with an increasing elderly population that desires to ...
journal_title:Acta orthopaedica
pub_type: 杂志文章,评审
doi:10.1080/17453674.2017.1368899
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The aims of this study were to quantify the risk and identify the causes of early postoperative mortality after total hip arthroplasty. This would help clinicians address preventable causes of death and help in accurate counseling and consenting of patients. METHODS:We determined the death rate at 90 days i...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610046244
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Several mechanisms are responsible for patellar dislocation. We investigated how the primary pathomechanism relates to patient characteristics and the outcome. METHODS:126 patients (81 females) with primary patellar dislocation reported the knee position before the episode, the movement during i...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453670903110634
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Gamma irradiation has been widely used for sterilization of bone allografts. However, gamma irradiation alters proteins. This is favorable when it reduces immunogenicity, but is undesirable when osteoinductive proteins are damaged. Although the effect of gamma irradiation on BMPs has been studied, the effect...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610013394
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Tourniquet-related nerve injuries remain a concern in orthopedic surgery. The cuff pressures used today are generally lower, and therefore a decreasing incidence of peripheral nerve injuries might also be expected. However, there have been few neurophysiological studies describing the outcome aft...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2013.782525
更新日期:2013-04-01 00:00:00
abstract::Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2017.1334180
更新日期:2017-10-01 00:00:00
abstract::Background and purpose - A risk-stratification algorithm for metal-on-metal hip arthroplasty (MoMHA) patients was devised by US experts to help clinicians make management decisions. However, the proposed algorithm did not cover all potential patient or surgical abnormalities. Therefore we adapted the US risk-stratific...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2019.1659661
更新日期:2019-12-01 00:00:00
abstract::Background and purpose - The number of primary, highly constrained knee arthroplasty implants has increased with a theoretically increased risk of early failure. Therefore we analyzed the risk of all revision following total knee arthroplasty (TKA) in patients receiving a hinged or condylar constrained knee (CCK) comp...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2019.1627638
更新日期:2019-10-01 00:00:00
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journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.3109/17453674.2014.1001970
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Following transtibial amputation, a rigid dressing of plaster of Paris has been reported to have advantages over a soft dressing regarding wound healing and reduction of edema, but use of the former may be limited by difficulties in application and in gaining access to the wound. An easily applic...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453670710015265
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:Treatment of proximal humerus fractures in elderly patients is challenging because of reduced bone quality. We determined the in vitro characteristics of a new implant developed to target the remaining bone stock, and compared it with an implant in clinical use. METHODS:Following osteotomy, left and right h...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670710014031
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:The frontal pelvic plane has traditionally served as the reference plane for implantation of the acetabular cup during total hip arthroplasty, with referencing performed with the patient supine on the operating table. During daily activities in an upright position, the frontal pelvic plane changes from a hor...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670510045471
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:In Legg-Calvé-Perthes disease (LCPD), 4 major patterns (coxa plana, coxa magna, coxa vara, subluxation) of the femoral head are commonly observed. However, direct observation of pathological specimens is rarely possible. An animal model of LCPD may clarify the pathogenesis of femoral head deformity. ANIMALS...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610045678
更新日期:2006-02-01 00:00:00
abstract::Background and purpose - Unnecessary radiographic and clinical follow-ups are common in treatment of pediatric fractures. We hypothesized that follow-up radiographs are unnecessary to monitor union of physeal fractures of the distal tibia.Patients and methods - All 224 (147 boys) children under 16 years old treated fo...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2019.1643632
更新日期:2019-12-01 00:00:00
abstract::Background and purpose - Impaction bone grafting (IBG) is an established method in hip revision surgery to reconstruct loss of bone stock. There is limited knowledge concerning the actual bone remodelling process within the allograft. We investigated with repeated bone mineral density (BMD) measurements the biological...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2018.1460776
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Hip fracture (HF) in frail elderly patients is associated with poor physical recovery and death. There is often postoperative blood loss and the hemoglobin (Hb) threshold for red blood cell (RBC) transfusions in these patients is unknown. We investigated whether RBC transfusion strategies were as...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.3109/17453674.2015.1006980
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Treatment of fractures of the humeral head remains controversial. We reviewed the outcome of our treatment of 2- and 3-part fractures of the proximal humerus using external fixation as a way of preventing damage to the vascularity of the humeral head and of reducing the risk of infection associated with open...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610046028
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Hospital-specific variation in outcome is generally considered to be an important source of information for clinical improvement. We have measured the magnitude of this variation. METHODS:We determined the revision risk in 37,642 cemented primary total knee arthroplasties inserted as a result of osteoarthri...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610046442
更新日期:2006-06-01 00:00:00
abstract::Background and purpose - The long-term effects of computer-assisted surgery in total knee replacement (CAS) compared to conventionally operated knee replacement (CON) are still not clear. We compared survivorship and relative risk of revision in CAS and CON based on data from the Norwegian Arthroplasty Register. Patie...
journal_title:Acta orthopaedica
pub_type: 杂志文章,多中心研究
doi:10.1080/17453674.2016.1244884
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:We have previously reported that 6 months of oral treatment with clodronate reduced the migration of the NexGen total knee prosthesis during the first postoperative year, as measured by radiostereometry (RSA). We now report the 4-year results. METHODS:This was a double-blind randomized study, using RSA with...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453670610013213
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Overweight and a high level of physical activity are known risk factors for loosening of a total hip arthroplasty (THA) due to primary osteoarthritis. We wanted to investigate how these factors, together with age and sex, affect the risk of revision surgery. PATIENTS AND METHODS:We matched data from the Nor...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453670610013493
更新日期:2007-02-01 00:00:00
abstract::Background and purpose - Discharge on the day of surgery (DOS) in selected patients operated with total hip arthroplasty (THA) or total knee arthroplasty (TKA) has been shown to be feasible, but different factors may determine whether patients are discharged on the DOS or not and setting may be one of them. We investi...
journal_title:Acta orthopaedica
pub_type: 杂志文章,随机对照试验
doi:10.1080/17453674.2019.1686205
更新日期:2020-02-01 00:00:00
abstract::Background and purpose - Several surgical approaches are used in primary total hip arthroplasty (THA). In this randomized controlled trial we compared gait, risk of fall, self-reported and clinical measurements between subjects after direct superior approach (DSA) versus posterolateral approach (PL) for THA. Patients ...
journal_title:Acta orthopaedica
pub_type: 杂志文章
doi:10.1080/17453674.2020.1865633
更新日期:2021-01-07 00:00:00