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Influence of fast-track programs on patient-reported outcomes in total hip and knee replacement (THR/TKR) at Swedish hospitals 2011-2015: an observational study including 51,169 THR and 8,393 TKR operations

Berg, Urban (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Sahlgrenska Academy
W-Dahl, Annette (author)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Swedish Knee Arthroplasty Register
Rolfson, Ola, 1973 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Swedish Hip Arthroplasty Register,Sahlgrenska Academy,Sahlgrenska University Hospital
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Naucler, E. (author)
Swedish Hip Arthroplasty Register
Sundberg, Martin (author)
Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Forskningsgruppen för höft- och knäproteskirurgi,Forskargrupper vid Lunds universitet,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,The Hip and Knee Joint Arthroplasty Research Group,Lund University Research Groups,Swedish Knee Arthroplasty Register
Nilsdotter, Anna (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för ortopedi,Institute of Clinical Sciences, Department of Orthopaedics,Sahlgrenska Academy,Sahlgrenska University Hospital
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 (creator_code:org_t)
2020-02-28
2020
English.
In: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 91:3, s. 306-312
  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Background and purpose - Fast-track care programs have been broadly introduced at Swedish hospitals in elective total hip and knee replacement (THR/TKR). We studied the influence of fast-track programs on patient-reported outcomes (PROs) 1 year after surgery, by exploring outcome measures registered in the Swedish arthroplasty registers. Patients and methods - Data were obtained from the Swedish Knee and Hip Arthroplasty Registers and included TKR and THR operations 2011-2015 on patients with osteoarthritis. Based on questionnaires concerning the clinical pathway and care programs at Swedish hospitals, the patients were divided in 2 groups depending on whether they had been operated in a fast-track program or not. PROs of the fast-track group were compared with not fast-track using regression analysis. EQ-5D, EQ VAS, Pain VAS, and Satisfaction VAS were analyzed for both THR and TKR operations. The PROMs for TKR also included KOOS. Results - The differences of EQ-5D, EQ VAS, Pain VAS, and Satisfaction VAS 1 year after surgery were small but all in favor of fast-track for both THR and TKR, also in subscales of KOOS for TKR except KOOS QoL. However, the effect sizes as measured by Cohens' d formula were < 0.2 for all PROs, in both THR and TKR. Interpretation - Our results indicate that the fast-track programs may be at least as good as conventional care from the perspective of PROs 1-year postoperatively.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopaedics (hsv//eng)

Keyword

quality-of-life
enhanced recovery
tourniquet use
elective hip
arthroplasty
experience
surgery
osteoarthritis
satisfaction
length
Orthopedics

Publication and Content Type

ref (subject category)
art (subject category)

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