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Rapid Recovery After Total Joint Arthroplasty Using General Anesthesia
Jeffrey B Stambough1, G Barnes Bloom2, Paul K Edwards1
1Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
The Journal of Arthroplasty
|June 17, 2019
Summary
Modern general anesthesia (GA) protocols can be successfully used for short-stay total joint arthroplasty (TJA). This study found high discharge rates and early physical therapy participation with low complication rates in 1527 TJAs.
Area of Science:
- Orthopedic Surgery
- Anesthesiology
- Patient Outcomes
Background:
- Spinal anesthesia is often preferred for total joint arthroplasty (TJA).
- Limited data exists on modern general anesthesia (GA) regimens in high-volume TJA centers.
Purpose of the Study:
- To evaluate the efficacy of a contemporary general anesthesia protocol for primary total joint arthroplasty.
- To assess outcomes including length of stay, recovery, complications, and readmissions.
Main Methods:
- Retrospective review of 1527 primary TJAs (hip and knee) over 3 years.
- Analysis of data from a single institution using a contemporary GA protocol.
- Case series (Level of Evidence IV).
Main Results:
- 96.3% of patients discharged on postoperative day 1.
- 97.2% participated in physical therapy on the day of surgery.
- Low rates of ICU stay (0.4%), 90-day readmission (2.4%), and reoperation (1.3%).
Conclusions:
- Modern GA techniques, limiting narcotics and certain inhalants, are effective for short-stay primary TJA.
- These findings support the use of GA in enhanced recovery pathways for TJA.
- GA can achieve similar positive outcomes to neuraxial anesthesia in high-volume TJA settings.
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