Abstract— Traditionally total knee and hip arthroplasty surgeries requires long duartion of hospital stay. More duration of stay has its own disadvantages. So it was tried to developed an accelerated clinical pathway for patients undergoing total knee arthroplasty (TKA) and total hip arthroplasty (THA) who are considered healthy enough for early discharge. Between March 2013 – April 2014, 89 TKA and 116 THA were performed to different patients at a single institution by a single orthopedic surgeon. 71 (31 TKA, 40 THA) met the inclusion criteria for the study. All patients received 2 grams of tranexamic acid and 750 mg cefuroxime sodium intravenously at 30 minutes prior to surgery. A multi-modal protocol for perioperative pain management was used for all patients. Out of total 71 patients (12 males, 59 females) with a mean age of 59 years (range, 24-79 years). The mean length of hospital stay was 27,3 hours (range, 15-60 hours). The mean duration of surgery was 92 minutes (range, 75-128 minutes) for TKA, 72 minutes (range, 48-81 minutes) for THA. Combined spinal epidural anesthesia was performed in 55 patients (77%) and general anesthesia in 16 patients (23%). Of the total 71 patients, 51 (71,8%) were discharged within 23 hours after surgery. Only 11(15.5%) were re-addmitted because of minor complains. These results of this study demonstrated that early discharge does not result in significant complications related to the outpatient procedure in selected patients up to three months postoperatively.
Keywords: Outpatient, Total Hip Arthroplasty, Total Knee Arthroplasty, Anesthesia.
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