Comparison of outcome measures from different pathways following total knee arthroplasty

Chan, Hiok Yang; Sultana, Rehena; Yeo, Seng Jin; Chia, Shi‐Lu; Pang, Hee Nee; Lo, Ngai Nung

doi:10.11622/smedj.2018011

Cited by 11 publications

(17 citation statements)

References 67 publications

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“…They concluded that older, female and less educated patients with poorer preoperative functional scores were more likely to be discharged to CHs after TKA. At the two-year follow-up, patients in CHs had less improvement in functional outcomes than those discharged home [9,10] .…”

Section: Discussionmentioning

confidence: 91%

Impact of socioeconomic factors on outcome of total knee arthroplasty

Prakash¹,

Bhanushali²,

Mishra³

2020

Int. J. Orthop. Sci.

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Background: Several factors are associated to negative outcomes of total joint replacement such as inappropriate expectations, contralateral knee pain, higher psychological distress, high body mass index, use of a walking aid, advanced age, female gender, lower OA grade and thyroid disease Nonetheless, these findings are often not consistent across studies and the exact strength of the associations between these factors and the outcomes remain elusive. It thus remains a challenge to identify which TKA candidates will likely do well, or do poorly following TKA. Aim of the study:To study Impact of Socioeconomic Factors on Outcome of Total Knee Arthroplasty. Materials and methods: A total of 60 patients were selected with 30 patients selected from each low socioeconomic group and high socioeconomic group. Patients who had rheumatoid arthritis or were undergoing revision TKA were excluded from the study. Evaluation was done clinically using Knee society score (KSS), VAS Score and Modified Kuppusamy Socioeconomic status scale. Results: VAS score for Group 1 dropped significantly from 1 st postoperative day to 2 nd postoperative day. After 2 nd day, the VAS score decreased gradually. The mean VAS score in Group 2 decreased gradually from 1 st postoperative day to 14 th day postoperatively. On 24 th week postoperatively, the mean VAS score was similar in both the groups. The mean difference between Group 1 and Group 2 Knee society score preoperatively was 7.1. At time of discharge, the mean difference dropped to 3.04 and was observed to be 4 at 3 rd week post-operatively. The mean difference dropped gradually till 6 th month postoperatively. Majority of patients in Group 1 had DVT prophylaxis up to day 6, but it was up to day 9 in Group 2. Thus, low income is more strongly associated with satisfaction and functional outcomes in young patients after TKA than demographic or implant factors. Conclusion:Within the limitations of the present study, it can be concluded that it is certainly possible that socioeconomic factors, particularly household income, is strongly associated with satisfaction and functional results.

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Section: Discussionmentioning

confidence: 91%

Impact of socioeconomic factors on outcome of total knee arthroplasty

Prakash¹,

Bhanushali²,

Mishra³

2020

Int. J. Orthop. Sci.

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“…In the "Model for Perioperative Orthopaedic Education via Telehealth" section, the EDUCATE principles are utilized to form the content, pace, and mode of instruction for the preoperative and postoperative education that is tailored to the needs of the patient. At discharge, patients encounter different challenges in physical, social, and environmental contexts, leading to unmet educational needs that are specific to their situations (Cano-Plans et al, 2018;Conradsen et al, 2016;Groeneveld et al, 2020;Tilbury et al, 2016) and can lead to poor outcomes (Chan et al, 2018). Patients who have undergone orthopaedic joint replacement surgery may need to travel great distances for quality care, may lack access to transportation, may have limited financial means to leave home, and may be dealing with the effects of pain and limited mobility after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…When other types of orthopaedic conditions are considered, that number is even greater. With any type of orthopaedic surgery, there is a risk of poor outcomes such as pain and decreased mobility (Chan et al, 2018) and decreased function with daily activities (Tilbury et al, 2016). In addition, patients may not be adequately prepared for discharge if they struggle to comprehend or retain information (Causey-Upton et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

A Model for Delivery of Orthopaedic Perioperative Education via Telehealth

Keener

Howell

2022

Orthopaedic Nursing

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With orthopaedic surgery, there is a risk of poor outcomes such as pain, decreased mobility, and decreased function, particularly if patients do not receive adequate preoperative and postoperative orthopaedic education. Healthcare education delivered via telehealth can be individualized to the patient's specific situation and health literacy level and is accessible, convenient, and timely for patients and providers. The purpose of this article is to combine two models of best practice, the EDUCATE model of patient education and Bashshur's Taxonomy of Telehealth, to describe a framework for improving delivery of preoperative and postoperative orthopaedic education. This innovative model presents a patient-centered approach to orthopaedic education that can increase patient comprehension and retention and address health literacy, through consideration of three dimensions essential for effective telehealth programs: functionality, application, and technology. Applications of the model are presented.

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“…1). Of these, four RCTs evaluated novel (hypothesized better) rehabilitation programs versus standard care or alternative rehabilitation programs, 37,40,53,73 four RCTs evaluated comparatively similar rehabilitation programs delivered with varying intensity and/or timing, 46,49,54,85 six studies (3 RCTs, 3 NRCSs) evaluated comparatively similar rehabilitation programs delivered in different settings or by different personnel, 32,35,47,63,64,67 and seven RCTs evaluated comparatively similar rehabilitation programs with or without an adjunctive modality. 28,42,72,78,80,84,86 Acute-phase rehabilitation interventions were initiated inhospital from immediately postop to 2 wks after surgery.…”

Section: Description Of the Acute-phase Rehabilitation For Tka Evidencementioning

confidence: 99%