A comprehensive joint replacement program for total knee arthroplasty: a descriptive study

Area of Science:

• Orthopedics
• Surgical Outcomes
• Rehabilitation Medicine

Background:

• Total knee arthroplasty (TKA) is a prevalent surgical procedure in the United States.
• Optimizing patient outcomes and minimizing adverse events in TKA necessitates a robust inpatient program.
• This study details the Joint Replacement Program (JRP) and evaluates its post-surgical outcomes.

Purpose of the Study:

• To describe the components and implementation of the Joint Replacement Program (JRP) for TKA.
• To report and analyze the post-surgical outcomes of patients undergoing TKA within the JRP.
• To assess the efficacy of a multidisciplinary, patient-centered approach in TKA care.

Main Methods:

• Enrolled 74 primary TKA candidates in the JRP, emphasizing a team approach.
• Implemented a program including pre-operative education, standardized care pathways, pain management, physical therapy (PT), and discharge planning.
• Collected data on functional tests, knee range of motion (ROM), length of stay, discharge disposition, and complications over six months.

Main Results:

• Patients achieved a mean knee flexion ROM of 91.7 degrees, but not the 0-degree extension goal (2.4 degrees).
• The majority of patients (53%) had a two-day length of stay, with most discharged home independently.
• Complications were low, with <3% experiencing inpatient medical issues and 12% over six months.

Conclusions:

• The JRP for TKA demonstrated satisfactory clinical outcomes, including short hospital stays and high rates of home discharge with outpatient PT.
• The program was associated with minimal complications, suggesting efficiency and safety.
• The JRP may serve as an effective model for post-TKA care protocols.