Randomised Controlled Study Comparing Fast Track and Standard Care Protocol on the Functional Outcomes and Hospital Stay of Total Knee Arthroplasty
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Osteoarthritis, Knee
- Sponsor
- Istituto Ortopedico Rizzoli
- Enrollment
- 64
- Locations
- 1
- Primary Endpoint
- Early functional outcomes
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery. The aim of this protocol is to compare the standard care and fast track total knee arthroplasties in terms of functional and subjective outcomes, hospital staying, number of transfusions and analgesic consumption.
Detailed Description
The aim of this protocol is to compare standard care and fast track total knee arthroplasties. The fast track care consists of: * preoperative educational lesson in which orthopedic surgeon, anesthesiologist and physiotherapist illustrate the operative and post operative path to the patients * antalgic protocol administered only orally * early rehabilitation care. The day of the surgical operation, the physiotherapist helps the patient reach the upright position. The standard care consists of usual antalgic and physiotherapy post-operative care: * Antalgic protocol consist in intravenous drugs * the first physiotherapy session is the day after surgery.
Investigators
Eligibility Criteria
Inclusion Criteria
- •patients affected by knee osteoarthritis, eligible for primary total knee arthroplasty
- •BMI \< 32
- •Time up ang go test \</= 12 seconds
- •American Society of Anesthesiologists physical status classification system (ASA) \</= 2
- •preoperative hemoglobin (HB) \>13 g/dl
- •patients eligible for spinal anesthesia
- •presence of a care-giver
Exclusion Criteria
- •psychiatric diseases
- •preoperative use of crutches
- •preoperative HB \< 13 g/dl
Outcomes
Primary Outcomes
Early functional outcomes
Time Frame: Third post operative day
Early functional outcomes are collecting using Lowa Level of Assistance(ILOA) during the third post-operative day. This scale is able to provide data on the autonomy reached by the patient in the first postoperative period going to investigate five main motor activities (get up from supine to seated, from sitting to standing position, walk around, take three steps, the speed of walking). the total score can vary from 0 to 50, where 50 indicates better functional results.
Secondary Outcomes
- hospital staying(Third day after surgery)
- Number of transfusions(Third day after surgery)
- Analgesic consumption(Third day after surgery)
- Knee Society Score (KSS) at third month(third month after surgery)
- Knee Society Score (KSS) at sixth month(sixth month after surgery)
- Knee Society Score (KSS) at twelfth month(twelfth month after surgery)
- Oxford Score (OS) at 6 weeks(6 weeks after surgery)
- Incidence of early major complications(Third day after surgery)
- Oxford Score (OS) at sixth month(sixth month after surgery)
- Knee Society Score (KSS) at 6 weeks(6 weeks after surgery)
- Oxford Score (OS) at third month(third month after surgery)
- Oxford Score (OS) at twelfth month(twelfth month after surgery)