Enhanced multimodal treatment protocols can shorten length of stay for total knee arthroplasty patients, according to new research published in the Journal of Orthopaedic Experience & Innovation.
Led by Maryann Stevenson and Andrew Wickline, MD, the study evaluated 386 prospective and consecutive TKA patients. The patients followed a multimodal protocol that involved an education and optimization program, home-based physical therapy and administration of a continuous adductor canal block.
Four findings:
1. After 12 weeks, 86.3 percent of the patients required 10 or fewer opioid pills. Just under 20 percent didn't require any opioid pills in that time frame.
2. About half of the patients took tramadol instead of more powerful opioids, and about 85 percent of the patients didn't require formal physical therapy after 12 weeks.
3. Same-day discharge occurred for about 63 percent of patients. More than 90 percent were discharged by the first postoperative day.
4. The 90-day readmission rate for TKA patients enrolled in the four-month protocol was 1.2 percent.
"A novel multimodal protocol combining consistent and patient specific preoperative education, CACB, and self-directed and unsupervised postoperative rehabilitation dramatically reduces narcotic needs, formal physical therapy needs, and decreases length of stay following TKA," the study authors concluded.
Click here to access the study.