One-day surgery is safe and effective in unicompartmental knee arthroplasty: A prospective comparative study at 1 year of follow-up.
1‐day surgery protocol
anteromedial or anterolateral knee osteoarthritis
early mobilisation
enhanced recovery after surgery
medial unicompartmental knee arthroplasty
pain management strategies
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
11 Jul 2024
11 Jul 2024
Historique:
revised:
23
06
2024
received:
28
04
2024
accepted:
24
06
2024
medline:
11
7
2024
pubmed:
11
7
2024
entrez:
11
7
2024
Statut:
aheadofprint
Résumé
To compare the outcomes and complications of two perioperative protocols for the management of patients who underwent medial unicompartmental knee arthroplasty (UKA): 24 h (1-day surgery [OS]) versus 72 h (enhanced recovery after surgery [ERAS]) of the length of hospital stay (LOS). In our hypothesis, the reduction of the LOS from 3 to 1 day did not influence the outcomes and complications. A total of 42 patients (21 in each group) with isolated anteromedial knee osteoarthritis and meeting specific criteria were prospectively included in the study. Clinical outcomes included Knee Society Score (KSS) and Forgotten joint score while pain evaluation was performed using a Visual Analogue Scale (VAS). Functional outcomes were assessed measuring the knee range of motion (ROM) while radiographic outcomes were evaluated measuring the amelioration of the varus deformity through the hip-knee-ankle angle (HKA). Clinical and functional outcomes did not significantly differ between the two groups. Complications occurred in 9.5% of OS and 4.7% of ERAS group patients. Significant improvements in knee ROM, VAS pain, KSS and HKA angle were observed postsurgery, with no significant differences between groups except in KSS expectations and function trends. The OS protocol is safe and effective and LOS, in a well-defined fast-track protocol, did not significantly impact clinical and functional outcomes. OS may lead to reduced hospitalisation costs and potential reductions in complications associated with prolonged stays, benefiting both patients and healthcare facilities. However, further research with larger sample sizes and longer follow-up periods is needed to confirm these findings. Early mobilisation and rehabilitation protocols are key components of successful patient recovery following UKA procedures. Level II.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Italian Ministry of Health, 'Ricerca Corrente'
Informations de copyright
© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.
Références
Andersen, L.Ø. & Kehlet, H. (2014) Analgesic efficacy of local infiltration analgesia in hip and knee arthroplasty: a systematic review. British Journal of Anaesthesia, 113(3), 360–374. Available from: https://doi.org/10.1093/bja/aeu155
Arirachakaran, A., Choowit, P., Putananon, C., Muangsiri, S. & Kongtharvonskul, J. (2015) Is unicompartmental knee arthroplasty (UKA) superior to total knee arthroplasty (TKA)? a systematic review and meta‐analysis of randomized controlled trial. European Journal of Orthopaedic Surgery & Traumatology, 25(5), 799–806. Available from: https://doi.org/10.1007/s00590-015-1610-9
Bradley, B., Middleton, S., Davis, N., Williams, M., Stocker, M., Hockings, M. et al. (2017) Discharge on the day of surgery following unicompartmental knee arthroplasty within the United Kingdom NHS. The Bone & Joint Journal, 99‐B(6), 788–792. Available from: https://doi.org/10.1302/0301-620X.99B6.BJJ-2016-0540.R2
Chiarotto, A., Maxwell, L.J., Ostelo, R.W., Boers, M., Tugwell, P. & Terwee, C.B. (2019) Measurement properties of visual analogue scale, numeric rating scale, and pain severity subscale of the brief pain inventory in patients with low back pain: a systematic review. The Journal of Pain, 20(3), 245–263. Available from: https://doi.org/10.1016/j.jpain.2018.07.009
Collins, N.J., Prinsen, C.A.C., Christensen, R., Bartels, E.M., Terwee, C.B. & Roos, E.M. (2016) Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta‐analysis of measurement properties. Osteoarthritis and Cartilage, 24(8), 1317–1329. Available from: https://doi.org/10.1016/j.joca.2016.03.010
Compagnoni, R., Puglia, F., Magnani, M., Klumpp, R., Ferrua, P., Calanna, F. et al. (2024) Optimised fast‐track protocols in total knee arthroplasty determine shorter hospitalisation time and lower perioperative/postoperative complications. Knee Surgery, Sports Traumatology, Arthroscopy, 32(4), 963–977. Available from: https://doi.org/10.1002/ksa.12122
Cross, M.B. & Berger, R. (2014) Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. International Orthopaedics, 38(2), 443–447. Available from: https://doi.org/10.1007/s00264-013-2214-9
Dervin, G.F., Madden, S.M., Crawford‐Newton, B.A., Lane, A.T. & Evans, H.C. (2012) Outpatient unicompartment knee arthroplasty with indwelling femoral nerve catheter. The Journal of Arthroplasty, 27(6), 1159–1165.e1. Available from: https://doi.org/10.1016/j.arth.2012.01.009
Fillingham, Y.A., Ramkumar, D.B., Jevsevar, D.S., Yates, A.J., Shores, P., Mullen, K. et al. (2018) The efficacy of tranexamic acid in total knee arthroplasty: a network meta‐analysis. The Journal of Arthroplasty, 33(10), 3090–3098.e1. Available from: https://doi.org/10.1016/j.arth.2018.04.043
Ford, M.C., Walters, J.D., Mulligan, R.P., Dabov, G.D., Mihalko, W.M., Mascioli, A.M. et al. (2020) Safety and cost‐effectiveness of outpatient unicompartmental knee arthroplasty in the ambulatory surgery center. Orthopedic Clinics of North America, 51(1), 1–5. Available from: https://doi.org/10.1016/j.ocl.2019.08.001
Gill, J.R., Corbett, J.A., Wastnedge, E. & Nicolai, P. (2021) Forgotten joint score: comparison between total and unicondylar knee arthroplasty. The Knee, 29, 26–32. Available from: https://doi.org/10.1016/j.knee.2021.01.009
Giorgino, R., Albano, D., Fusco, S., Peretti, G.M., Mangiavini, L. & Messina, C. (2023) Knee osteoarthritis: epidemiology, pathogenesis, and mesenchymal stem cells: what else is new? an update. International Journal of Molecular Sciences, 24(7), 6405. Available from: https://doi.org/10.3390/ijms24076405
Gondusky, J.S., Choi, L., Khalaf, N., Patel, J., Barnett, S. & Gorab, R. (2014) Day of surgery discharge after unicompartmental knee arthroplasty: an effective perioperative pathway. The Journal of Arthroplasty, 29(3), 516–519. Available from: https://doi.org/10.1016/j.arth.2013.08.021
Goslings, J.C. & Gouma, D.J. (2008) What is a surgical complication? World Journal of Surgery, 32(6), 952. Available from: https://doi.org/10.1007/s00268-008-9563-3
Hjermstad, M.J., Fayers, P.M., Haugen, D.F., Caraceni, A., Hanks, G.W., Loge, J.H. et al. (2011) Studies comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for assessment of pain intensity in adults: a systematic literature review. Journal of Pain and Symptom Management, 41(6), 1073–1093. Available from: https://doi.org/10.1016/j.jpainsymman.2010.08.016
Hoorntje, A., Koenraadt, K.L.M., Boevé, M.G. & van Geenen, R.C.I. (2017) Outpatient unicompartmental knee arthroplasty: who is afraid of outpatient surgery? Knee Surgery, Sports Traumatology, Arthroscopy, 25(3), 759–766. Available from: https://doi.org/10.1007/s00167-017-4440-y
Jæger, P., Zaric, D., Fomsgaard, J.S., Hilsted, K.L., Bjerregaard, J., Gyrn, J. et al. (2013) Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty: a randomized, double‐blind study. Regional Anesthesia and Pain Medicine, 38(6), 526–532. Available from: https://doi.org/10.1097/AAP.0000000000000015
Kehlet, H. (2013) Fast‐track hip and knee arthroplasty. The Lancet, 381(9878), 1600–1602. Available from: https://doi.org/10.1016/S0140-6736(13)61003-X
Koh, I.J., Choi, Y.J., Kim, M.S., Koh, H.J., Kang, M.S. & In, Y. (2017) Femoral nerve block versus adductor canal block for analgesia after total knee arthroplasty. Knee Surgery & Related Research, 29(2), 87–95. Available from: https://doi.org/10.5792/ksrr.16.039
Koh, H.J., Koh, I.J., Kim, M.S., Choi, K.Y., Jo, H.U. & In, Y. (2017) Does patient perception differ following adductor canal block and femoral nerve block in total knee arthroplasty? a simultaneous bilateral randomized study. The Journal of Arthroplasty, 32(6), 1856–1861. Available from: https://doi.org/10.1016/j.arth.2017.01.025
Kohn, M.D., Sassoon, A.A. & Fernando, N.D. (2016) Classifications in brief: Kellgren‐Lawrence Classification of osteoarthritis. Clinical Orthopaedics & Related Research, 474(8), 1886–1893. Available from: https://doi.org/10.1007/s11999-016-4732-4
Kort, N.P., Bemelmans, Y.F.L. & Schotanus, M.G.M. (2017) Outpatient surgery for unicompartmental knee arthroplasty is effective and safe. Knee Surgery, Sports Traumatology, Arthroscopy, 25(9), 2659–2667. Available from: https://doi.org/10.1007/s00167-015-3680-y
Kyriakidis, T., Asopa, V., Baums, M., Verdonk, R. & Totlis, T. (2023) Unicompartmental knee arthroplasty in patients under the age of 60 years provides excellent clinical outcomes and 10‐year implant survival: a systematic review: a study performed by the Early Osteoarthritis group of ESSKA‐European Knee Associates section. Knee Surgery, Sports Traumatology, Arthroscopy, 31(3), 922–932. Available from: https://doi.org/10.1007/s00167-022-07029-9
Lee, N.K., Lee, S.I. & Chang, C.B. (2023) The limited use of a tourniquet during total knee arthroplasty under a contemporary enhanced recovery protocol has no meaningful benefit: a prospective randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 31(3), 1089–1097. Available from: https://doi.org/10.1007/s00167-022-07228-4
Leiss, F., Götz, J.S., Maderbacher, G., Zeman, F., Meissner, W., Grifka, J. et al. (2020) Pain management of unicompartmental (UKA) vs. total knee arthroplasty (TKA) based on a matched pair analysis of 4144 cases. Scientific Reports, 10(1), 17660. Available from: https://doi.org/10.1038/s41598-020-74986-x
Li, J., Liu, R., Rai, S., Ze, R., Tang, X. & Hong, P. (2020) Intra‐articular vs. intravenous administration: a meta‐analysis of tranexamic acid in primary total knee arthroplasty. Journal of Orthopaedic Surgery and Research, 15(1), 581. Available from: https://doi.org/10.1186/s13018-020-02119-1
Liddle, A.D., Pandit, H., Judge, A. & Murray, D.W. (2015) Optimal usage of unicompartmental knee arthroplasty: a study of 41,986 cases from the National Joint Registry for England and Wales. The Bone & Joint Journal, 97‐B(11), 1506–1511. Available from: https://doi.org/10.1302/0301-620X.97B11.35551
Liddle, A.D., Pandit, H., Judge, A. & Murray, D.W. (2015) Patient‐reported outcomes after total and unicompartmental knee arthroplasty: a study of 14,076 matched patients from the National Joint Registry for England and Wales. The Bone & Joint Journal, 97‐B(6), 793–801. Available from: https://doi.org/10.1302/0301-620X.97B6.35155
Lloyd, M., Sugden, N., Thomas, M., McGrath, A. & Skilbeck, C. (2023) The structure of the Hospital Anxiety and Depression Scale: theoretical and methodological considerations. British Journal of Psychology, 114(2), 457–475. Available from: https://doi.org/10.1111/bjop.12637
Marya, S.K.S., Arora, D., Singh, C., Kacker, S., Desai, R. & Lodha, V. (2020) A prospective comparative study of local infiltration versus adductor block versus combined use of the two techniques following knee arthroplasty. Arthroplasty, 2(1), 15. Available from: https://doi.org/10.1186/s42836-020-00034-8
Miralles‐Muñoz, F.A., Gonzalez‐Parreño, S., Martinez‐Mendez, D., Gonzalez‐Navarro, B., Ruiz‐Lozano, M., Lizaur‐Utrilla, A. et al. (2022) A validated outcome categorization of the knee society score for total knee arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, 30(4), 1266–1272. Available from: https://doi.org/10.1007/s00167-021-06563-2
Munk, S., Dalsgaard, J., Bjerggaard, K., Andersen, I., Hansen, T.B. & Kehlet, H. (2012) Early recovery after fast‐track Oxford unicompartmental knee arthroplasty. 35 patients with minimal invasive surgery. Acta Orthopaedica, 83(1), 41–45. Available from: https://doi.org/10.3109/17453674.2012.657578
Nakasone, C.K., Combs, D., Buchner, B. & Andrews, S. (2020) Day of surgery discharge success after implementation of a rapid discharge protocol following unilateral unicompartmental knee arthroplasty. The Knee, 27(3), 1043–1048. Available from: https://doi.org/10.1016/j.knee.2020.03.003
Nielsen, C.S., Jans, Ø., Ørsnes, T., Foss, N.B., Troelsen, A. & Husted, H. (2016) Combined intra‐articular and intravenous tranexamic acid reduces blood loss in total knee arthroplasty: a randomized, double‐blind, placebo‐controlled trial. Journal of Bone and Joint Surgery, 98(10), 835–841. Available from: https://doi.org/10.2106/JBJS.15.00810
Romagnoli, S., Petrillo, S. & Marullo, M. (2021) Knee resurfacing with double unicompartimental arthroplasty: rationale, biomechanics, indications, surgical technique and outcomes. Journal of Experimental Orthopaedics, 8(1), 78. Available from: https://doi.org/10.1186/s40634-021-00402-6
Ruiz, N., Buisson, X., Filippi, G., Roulet, M., Robert, H. & Orthopedics and Traumatology Society of Western France. (2018) Ambulatory unicompartmental knee arthroplasty: Short outcome of 50 first cases. Orthopaedics & Traumatology, Surgery & Research, 104(7), 961–966. Available from: https://doi.org/10.1016/j.otsr.2017.10.004
Salman, L.A., Abudalou, A., Khatkar, H., Ahmed, G., Dakin, S.G., Kendrick, B. et al. (2023) Impact of age on unicompartmental knee arthroplasty outcomes: a systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy, 31(3), 986–997. Available from: https://doi.org/10.1007/s00167-022-07132-x
Sawhney, M., Mehdian, H., Kashin, B., Ip, G., Bent, M., Choy, J. et al. (2016) Pain after unilateral total knee arthroplasty: a prospective randomized controlled trial examining the analgesic effectiveness of a combined adductor canal peripheral nerve block with periarticular infiltration versus adductor canal nerve block alone versus periarticular infiltration alone. Anesthesia and Analgesia, 122(6), 2040–2046. Available from: https://doi.org/10.1213/ANE.0000000000001210
Schulz, K.F., Altman, D.G. & Moher, D., CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. BMJ, 340, c332. Available from: https://doi.org/10.1136/bmj.c332
Tay, M.L., Monk, A.P., Frampton, C.M., Hooper, G.J. & Young, S.W. (2023) The strongest Oxford knee score predictors of subsequent revision are “overall pain,” “limping when walking,” and “knee giving way”. The Journal of Arthroplasty, 38(7 Supplement 2), S156–S161.e3. Available from: https://doi.org/10.1016/j.arth.2023.03.001
Vora, M.U., Nicholas, T.A., Kassel, C.A. & Grant, S.A. (2016) Adductor canal block for knee surgical procedures: review article. Journal of Clinical Anesthesia, 35, 295–303. Available from: https://doi.org/10.1016/j.jclinane.2016.08.021
Wainwright, T.W., Gill, M., McDonald, D.A., Middleton, R.G., Reed, M., Sahota, O. et al. (2020) Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Acta Orthopaedica, 91(1), 3–19. Available from: https://doi.org/10.1080/17453674.2019.1683790
Wall, P.D.H., Sprowson, A.P., Parsons, N.R., Parsons, H., Achten, J., Balasubramanian, S. et al. (2017) A pragmatic randomised controlled trial comparing the efficacy of a femoral nerve block and periarticular infiltration for early pain relief following total knee arthroplasty. The Bone & Joint Journal, 99‐B(7), 904–911. Available from: https://doi.org/10.1302/0301-620X.99B7.BJJ-2016-0767.R2
Zhang, Y.M., Yang, B., Sun, X.D. & Zhang, Z. (2019) Combined intravenous and intra‐articular tranexamic acid administration in total knee arthroplasty for preventing blood loss and hyperfibrinolysis: a randomized controlled trial. Medicine, 98(7), e14458. Available from: https://doi.org/10.1097/MD.0000000000014458