TY - JOUR
T1 - Fast-track revision knee arthroplasty.
AU - Lindberg-Larsen, Martin
AU - Petersen, Pelle Baggesgaard
AU - Corap, Yasemin
AU - Gromov, Kirill
AU - Jørgensen, Christoffer Calov
AU - Kehlet, Henrik
PY - 2022/1/1
Y1 - 2022/1/1
N2 - BACKGROUND: Limited data exist on fast-track protocols in relation to revision knee arthroplasty. Hence, the aim of this study was to report length of stay (LOS), risk of LOS > 5 days and readmission ≤ 90 days after revision knee arthroplasty in centers with a well-established fast-track protocol in both primary and revision surgery.METHODS: An observational cohort study from the Centre for Fast-track Hip and Knee Replacement and the Danish Knee Arthroplasty Register. We included elective aseptic major component revision knee arthroplasties consecutively from 6 dedicated fast-track centers from 2010 to 2018.RESULTS: 1439 revision knee arthroplasties were analyzed, including 900 total revisions, 171 large partial revisions (revision of either femoral or tibia component) and 368 revisions of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA). Mean age was 65 years (SD 10.9) and 66% were females. Mean LOS was 3.7 days (SD 3.9) in the study period, but decreased to 2.4 days (SD 1.3) in 2018. Risk factors for LOS > 5 days was ≥ 1 previous revision, use of walking aid, BMI > 35, ages < 50, 70-79 and ≥ 80 years, whereas revision of UKA to TKA and large partial revision were negatively associated. The 90-day readmission and mortality risk was 9.1% and 0.5%. Cardiac disease and use of walking aid were associated with increased risk of readmission ≤ 90 days.CONCLUSION: Elective aseptic major component revision knee arthroplasty using similar fast-track protocols as in primary TKA is safe with short and decreasing LOS.
AB - BACKGROUND: Limited data exist on fast-track protocols in relation to revision knee arthroplasty. Hence, the aim of this study was to report length of stay (LOS), risk of LOS > 5 days and readmission ≤ 90 days after revision knee arthroplasty in centers with a well-established fast-track protocol in both primary and revision surgery.METHODS: An observational cohort study from the Centre for Fast-track Hip and Knee Replacement and the Danish Knee Arthroplasty Register. We included elective aseptic major component revision knee arthroplasties consecutively from 6 dedicated fast-track centers from 2010 to 2018.RESULTS: 1439 revision knee arthroplasties were analyzed, including 900 total revisions, 171 large partial revisions (revision of either femoral or tibia component) and 368 revisions of unicompartmental knee arthroplasty (UKA) to total knee arthroplasty (TKA). Mean age was 65 years (SD 10.9) and 66% were females. Mean LOS was 3.7 days (SD 3.9) in the study period, but decreased to 2.4 days (SD 1.3) in 2018. Risk factors for LOS > 5 days was ≥ 1 previous revision, use of walking aid, BMI > 35, ages < 50, 70-79 and ≥ 80 years, whereas revision of UKA to TKA and large partial revision were negatively associated. The 90-day readmission and mortality risk was 9.1% and 0.5%. Cardiac disease and use of walking aid were associated with increased risk of readmission ≤ 90 days.CONCLUSION: Elective aseptic major component revision knee arthroplasty using similar fast-track protocols as in primary TKA is safe with short and decreasing LOS.
KW - Revision knee arthroplasty
KW - Knee replacement
KW - Fast-track
KW - Rapid recovery
KW - Safety
KW - Readmissions
KW - Length of Stay
KW - Reoperation
KW - Humans
KW - Arthroplasty, Replacement, Hip/adverse effects
KW - Arthroplasty, Replacement, Knee/methods
KW - Aged, 80 and over
KW - Female
KW - Aged
KW - Elective Surgical Procedures/adverse effects
KW - Cohort Studies
UR - http://www.scopus.com/inward/record.url?scp=85125552110&partnerID=8YFLogxK
U2 - 10.1016/j.knee.2021.09.001
DO - 10.1016/j.knee.2021.09.001
M3 - Journal article
C2 - 34894588
SN - 0968-0160
VL - 34
SP - 24
EP - 33
JO - The Knee
JF - The Knee
ER -