Pre-operative health screening for total knee replacement

Area of Science:

• Orthopedics
• Rheumatology
• Healthcare Management

Background:

• Total knee replacement (TKR) is a common orthopedic procedure.
• Pre-operative assessments are crucial for patient safety and surgical success.
• Identifying and managing comorbidities pre-operatively can reduce surgical cancellations and postponements.

Purpose of the Study:

• To evaluate the impact of domiciliary pre-operative assessment by a rheumatology clinical nurse specialist on total knee replacement surgery scheduling.
• To identify medical and surgical issues that may lead to postponement or cancellation of TKR.

Main Methods:

• A prospective study involving 100 patients awaiting TKR at Wirral Hospitals.
• Domiciliary pre-operative assessment conducted by a rheumatology clinical nurse specialist.
• Documentation of identified medical and surgical problems influencing surgical readiness.

Main Results:

• Out of 100 patients assessed, 31% (31 patients) had their surgeries postponed.
• Seven patients (7%) had their surgeries cancelled due to identified medical or surgical problems.
• All patients eventually underwent surgery on their scheduled date without further delays after addressing the identified issues.

Conclusions:

• Domiciliary pre-operative assessment by rheumatology clinical nurse specialists is effective in identifying patient-specific issues prior to TKR.
• This assessment process helps optimize surgical candidacy, reduce cancellations, and improve patient flow.
• Implementing such assessments can enhance the efficiency and success rates of orthopedic surgical pathways.