Clinical pathways in total knee arthroplasty: a New Zealand experience

J Orthop Surg (Hong Kong). 2003 Dec;11(2):166-73. doi: 10.1177/230949900301100211.

Abstract

Purpose: To ascertain the effects of a clinical pathway in our institution.

Methods: This retrospective and comparative study was performed on all patients undergoing total knee arthroplasty over a 5-year period. This period covered the 30 months prior to the introduction of the pathway (group 1), and the 30 months following its introduction (group 2).

Results: There was a significant reduction in the duration of hospital stay of group 2 patients (p<0.0001), with 62.8% of these patients staying less than 8 postoperative days. There was a reduction in the number of patients with thromboembolic complications (p<0.05) and no increase in overall complications or readmission rate. There was a trend to increased use of rehabilitation services among group 2 patients.

Conclusion: Clinical pathway implementation resulted in a significant reduction in the length of stay, and achieved a more efficient management of hospitalised patients without compromising outcome.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / adverse effects
  • Arthroplasty, Replacement, Knee / methods*
  • Critical Pathways*
  • Female
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Retrospective Studies
  • Thromboembolism / etiology
  • Thromboembolism / prevention & control
  • Treatment Outcome