Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Knee
Abstract number: 25616
EARLY DISCHARGE AFTER UNICONDYLAR KNEE REPLACEMENT: A
DISTRICT GENERAL HOSPITAL EXPERIENCE IN A RURAL SETTING
Rahul KAKKAR, M.J DAWSON
Northern Deanery, Newcastle (UNITED KINGDOM)
A retrospective analysis of the patients operated at a district general hospital in a
rural setting in order to identify a cohort of patients that might be suitable for early
discharge after a unicondylar knee replacement. All patients underwent Unicondylar
knee replacement using the same implant (Oxford phase 3). Thirty patients' records
were analysed with respect to the following factors - co-morbidities, pre-operative
mobility, type of anaesthesia (general/ general with femoral/sciatic nerve block, spinal
anaesthesia using opioids/spinal anaesthesia using fentanyl) and post operative
analgesia. We then separated the patients who were discharged on first
postoperative day (early discharge) from those whose discharge was delayed. All
patients who received a femoral/sciatic nerve block had a delayed discharge
(average 3.1 days) due to poor quadriceps control and inability to progress with
physiotherapy. All patients who had received a spinal anaesthetic with fentanyl were
discharged on the first postoperative day but patients who received spinal
anaesthetic with opioid stayed in hospital for an average 3.2 days because they had
urinary or bowel retention or due to the systemic effects of the opioids. The average
stay for patients with general anaesthetic only was 2.5 days. Also, patients having
minimal comorbidities and good preoperative mobility stayed in hospital for average
1.8 days, compared to 4.3 days with significant comorbidities and poor mobility.
Therefore appropriate screening of patients before admission along with appropriate
anaesthesia and adequate postoperative analgesia can be used to achieve early
discharge of patients with UKR.
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