Reduced medium-term mortality following primary total hip and knee arthroplasty with an enhanced recovery program

@article{Savaridas2013ReducedMM,
  title={Reduced medium-term mortality following primary total hip and knee arthroplasty with an enhanced recovery program},
  author={Terence Savaridas and Ignacio Serrano-Pedraza and Sameer K Khan and Kate Martin and Ajay Malviya and Mike R Reed},
  journal={Acta Orthopaedica},
  year={2013},
  volume={84},
  pages={40 - 43}
}
Background and purpose Our unit started to use routine multimodal techniques to enhance recovery for hip and knee arthroplasty in 2008. We have previously reported earlier discharge, a trend toward a reduction in complications, and a statistically significant reduction in mortality up to 90 days after surgery. In this study, we evaluated the same cohort to determine whether survival benefits were maintained at 2 years. Patients and methods We prospectively evaluated 4,500 unselected consecutive… 

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...

References

SHOWING 1-10 OF 14 REFERENCES

Enhanced recovery program for hip and knee replacement reduces death rate

This large observational study of 4,500 consecutive unselected consecutive hip and knee arthroplasty patients shows a substantial reduction in death rate, reduced length of stay, and reduced transfusion requirements after the introduction of a multimodal enhanced recovery protocol.

Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: A randomized clinical trial involving 87 patients with 3 months of follow-up

An accelerated perioperative care and rehabilitation intervention in patients undergoing primary total hip replacement, and total or unicompartmental knee replacement is indeed effective—and of advantage to both the hospital and the patient.

Why still in hospital after fast-track hip and knee arthroplasty?

Pain, dizziness, and general weakness were the main clinical reasons for being hospitalized at 24 and 48 hours postoperatively while nausea, vomiting, confusion, and sedation delayed discharge to a minimal extent.

Determinants of Long-Term Survival After Major Surgery and the Adverse Effect of Postoperative Complications

The occurrence of a 30-day postoperative complication is more important than preoperative patient risk and intraoperative factors in determining the survival after major surgery in the VA.

Multimodal strategies to improve surgical outcome.

Evidence-Based Surgical Care and the Evolution of Fast-Track Surgery

Multimodal evidence-based care within the fast-track methodology significantly enhances postoperative recovery and reduces morbidity, and should therefore be more widely adopted.

Reduced hospital stay and narcotic consumption, and improved mobilization with local and intraarticular infiltration after hip arthroplasty: A randomized clinical trial of an intraarticular technique versus epidural infusion in 80 patients

Wound infiltration combined with 1 intraarticular injection of local anesthetics for pain relief after total hip arthroplasty with the well-established practice of epidural infusion can be recommended for patients undergoing THA.

The logrank test

The table shows survival times of 51 adult patients with recurrent malignant gliomas1 tabulated by type of tumour and indicating whether the patient had died or was still alive at analysis—that is, their survival time was censored.