Total diz artroplastisi uygulanan hastalarda rapıd recovery protokolünün etkinliği

Öz

Amaç: Total diz artroplastisi uygulanan hastalarda mevcut standart protokol ile rapid recovery protokolünü maliyet - etkinlik ve klinik sonuçlar açısından karşılaştırmaktır.

Hastalar ve Yöntem: Çalışmaya, primer elektif total diz artroplastisi uygulanan ve en az 6 aylık süre boyunca takip edilmiş olan hastalar dahil edildi. . Rapid recovery protokolü uygulanan 96 hasta (Grup 1) ile standart protokol uygulanmış olan 108 hasta (Grup 2) değerlendirmeye alındı. Tüm hastalara standart total diz artroplastisi uygulandı. Her iki prosedür de farklı tedavi planlarının felsefesine uygun olarak standardize edildi. Ameliyat sonrası hastanede yatış süresine, toplam finansal giderlere, ameliyat sonrası cerrahi enfeksiyon oranlarına, 6.ay AKSS fonksiyon skorlarına ve 6.ay diz fleksiyon – ekstansiyon derecelerine ait veriler hastaların kayıt dosyalarından toplanarak her iki grubun karşılaştırması yapıldı

Bulgular: Toplam 169 hasta değerlendirmeye alındı. Grup 1’deki hastaların postoperatif hastanede kalış süresi daha kısaydı ve istatistiksel olarak anlamlıydı (p=0.021). Grup 1’deki toplam maliyet daha düşüktü ve anlamlydı (p=0.041). Grup 1’deki enfeksiyon oranları daha düşüktü ve anlamlıydı (p=0.034). 6. aydaki AKSS fonksiyon skorları Grup 1’deki hastalarda daha yüksek ve anlamlıydı  (p=0.032). 6. aydaki fleksiyon ve ekstansiyon dereceleri Grup 1’deki hastalarda daha fazlaydı ve anlamlıydı  (Sırasyıla p=0.04, p=0.48)

Sonuç: Total diz artroplastisi yapılan hastalara rapid recovery protokolünün uygulanması ile toplam maliyetin azaldığı, enfeksiyon oranlarının azaldığı, hasta memnuniyetinin arttığı ve mükemmel fonksiyonel sonuçların alındığı görülmektedir. Rapid recovery protokolü hem total diz artroplastisi uygulanan hastalar için hem de sağlık hizmetini finanse eden kurumlar için oldukça faydalı olabilir.

Anahtar Kelimeler: Total diz artroplastisi, rapid recovery.

 

DOI: 10.3944/AOTT.2015.14.0353

 

Anahtar Kelimeler

• Maliyet etkinliği; rapid recovery; rehabilitasyon; total diz artroplastisi

Efficacy of rapid recovery protocol for total knee arthroplasty: a retrospective study

Abstract

Objective: Our aim was to compare the clinical results and cost-effectiveness of a rapid recovery protocol for total knee arthroplasty (TKA) with a current standard protocol.
Methods: The study included patients undergoing primary elective TKA with at least 6 months of follow-up. The rapid recovery protocol was applied to 96 patients (Group 1) and the standard protocol to 108 (Group 2). All patients underwent standard TKA. All pre-, peri-, and postoperative procedures in the treatment and follow-up of patients were appropriately standardized to the philosophies of the different treatment plans. The postoperative length of hospital stay, total financial cost, postoperative surgical infection, 6-month American Knee Society scores, and knee range of motion (ROM) were compared between the groups.
Results: A total of 169 patients were included. Group 1 patients had significantly shorter postoperative length of hospital stay (p=0.021), significantly lower mean total financial cost (p=0.041), significantly lower infection rates (p=0.034), and significantly higher 6-month knee function scores (p=0.032). In comparison with Group 2, Group 1 knee flexion (p=0.04) and extension (p=0.48) ROM at 6 months postoperatively were both significantly improved.
Conclusion: Application of the rapid recovery protocol to patients who underwent TKA reduced costs and infection rates and improved functional results.

Keywords

• Accelerated discharge
• cost-effectiveness
• rehabilitation
• total knee arthroplasty

Kaynakça

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