门诊同步双侧单室膝关节置换术：安全且患者报告结果良好

IF 3.4 2区医学 Q1 ORTHOPEDICS

Journal of Arthroplasty Pub Date : 2024-11-16 DOI:10.1016/j.arth.2024.11.030

Andrew M. Steffensmeier MD , Elijah Auch MD , Henry Haley MD , Kevin Farley MD , Donald Knapke MD

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引用次数: 0

摘要

背景：在医院环境中，当天（同时）完成的双侧单髁膝关节置换术（sbUKA）已被证明是安全且具有成本效益的。鉴于非卧床手术中心（ASC）的普及和使用的增加，本研究的目的是比较在医院和非卧床手术中心进行的膝关节置换术（sbUKA）的安全性和患者报告的结果指标（PROMs）：方法：回顾性地收集了5年来由一名外科医生完成的连续性初级sbUKA手术。手术在医院或 ASC 进行。收集了两组患者的基线人口统计学资料、术中和术后结果以及膝关节损伤和骨关节炎关节置换术结果评分（KOOS-jr）患者报告结果评分。对连续变量采用学生非配对 t 检验，对分类变量采用 χ2 检验：在146名接受sbUKA的患者（292个膝关节）中，90名在医院完成，56名在ASC完成。医院组的住院时间更长（53小时对5小时，P<0.001），手术时间更长（82分钟对68分钟，P<0.001）。在医院组中，有11人（12.2%）在120天内出院到亚急性康复中心（SAR），有9人（10%）返回急诊科（ED），而在ASC组中没有患者（P = 0.007和0.015，分别为0.007和0.015）。术后最终活动范围和KOOS-jr评分无明显差异：结论：SbUKA可以在门诊安全地为选定的患者实施。结论：门诊 SbUKA 可安全地用于特定患者，门诊 SbUKA 和住院 SbUKA 在功能结果上没有差异。

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Outpatient Simultaneous Bilateral Unicompartmental Knee Arthroplasties: Safe With Positive Patient-Reported Outcomes

Background

Bilateral unicompartmental knee arthroplasty (bUKA) done on the same day (simultaneous bUKA [sbUKA]) has been shown to be safe and cost-effective in hospital settings. Given the popularity and increased use of ambulatory surgery centers (ASCs), the purpose of this study was to compare safety and patient-reported outcome measures of sbUKA done at the hospital versus ASC.

Methods

Consecutive primary sbUKAs over five years done by a single surgeon were retrospectively collected. Surgeries were done at a hospital or ASC. Baseline demographics, intraoperative and postoperative results, and Knee injury and Osteoarthritis Outcome Score for Joint Replacement patient-reported outcome scores were collected between the two groups. Groups were compared using Student’s unpaired t-tests for continuous variables and χ² tests for categorical variables.

Results

Of 146 patients (292 knees) who underwent sbUKA, 90 were done at a hospital and 56 were done at an ASC. Length of stay was longer (53 versus five hours, P < 0.001), and operative time was longer (82 versus 68 minutes, P < 0.001) in the hospital group. In the hospital group, 11 (12.2%) were discharged to subacute rehab and nine (10%) returned to the emergency department within 120 days compared to zero patients in the ASC group (P = 0.007 and 0.015, respectively). There was no significant difference in the final range of motion or Knee injury and Osteoarthritis Outcome Score for Joint Replacement scores postoperatively.

Conclusions

Outpatient sbUKA can safely be performed in selected patients. There is no difference in functional outcomes between outpatient and inpatient sbUKA.

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来源期刊

Journal of Arthroplasty 医学-整形外科

CiteScore

7.00

自引率

20.00%

发文量

734

审稿时长

48 days

期刊介绍： The Journal of Arthroplasty brings together the clinical and scientific foundations for joint replacement. This peer-reviewed journal publishes original research and manuscripts of the highest quality from all areas relating to joint replacement or the treatment of its complications, including those dealing with clinical series and experience, prosthetic design, biomechanics, biomaterials, metallurgy, biologic response to arthroplasty materials in vivo and in vitro.