ArticleActa orthopaedica2018
Fast-tracking for total knee replacement reduces use of institutional care without compromising quality.
Article in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04653415 (The Impact of Pre-emptive Large Doses of Methylprednisolone Combined With Gabapentin on Pain Treatment and Convalescence After Total Knee Arthroplasty in Elderly), which is not on this map. Cited by 24 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Impact of Pre-emptive Large Doses of Methylprednisolone Combined With Gabapentin on Pain Treatment and Convalescence After Total Knee Arthroplasty in Elderly: A Double-blind Randomized Study
Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Hospital volume-outcome relationship in total knee arthroplasty: a systematic review and dose-response meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Economic analyses of fast-track total hip and knee arthroplasty: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Pooled it
- Pre-emptive analgesia with methylprednisolone and gabapentin in total knee arthroplasty in the elderly.Scientific reports · 2022Trial
- Fast-track total knee arthroplasty improved clinical and functional outcome in the first 7 days after surgery: a randomized controlled pilot study with 5-year follow-up.Archives of orthopaedic and trauma surgery · 2018Trial
- Coordinated Return-to-Work model reduces sickness absences after hip or knee arthroplasty: a registry-based study.Archives of orthopaedic and trauma surgery · 2026Article
- Return to Work Following Hip or Knee Arthroplasty: A One-Year Prospective Cohort Study in Participants with Direct Referral from Hospital to Occupational Health Care Services.Journal of occupational rehabilitation · 2025Article
- Effect of electroacupuncture stimulation combined with the enhanced recovery after surgery regimen on motor function recovery following total knee arthroplasty.Journal of neuroengineering and rehabilitation · 2025Article
- The incidence of venous thromboembolism is low when risk stratification-based thromboprophylaxis is used after fast-track hip and knee arthroplasty.BMC musculoskeletal disorders · 2024Article
- Does interaction occur between risk factors for revision total knee arthroplasty?Archives of orthopaedic and trauma surgery · 2024Article
- Readmission rate and early complications in patients undergoing total knee arthroplasty: A retrospective study.World journal of orthopedics · 2024Article
- Venous thromboembolism is rare after total hip and knee joint arthroplasty with long thromboprophylaxis in Finnish fast-track hospitals.Archives of orthopaedic and trauma surgery · 2023Article
- Isokinetic knee muscle strength comparison after enhanced recovery after surgery (ERAS) versus conventional setup in total knee arthroplasty (TKA): a single blinded prospective randomized study.Journal of experimental orthopaedics · 2023Article
- Effectiveness of Gamification in Knee Replacement Rehabilitation: Protocol for a Randomized Controlled Trial With a Qualitative Approach.JMIR research protocols · 2022Article
- Key Components, Current Practice and Clinical Outcomes of ERAS Programs in Patients Undergoing Orthopedic Surgery: A Systematic Review.Journal of clinical medicine · 2022Review
- Preoperative Patient Expectation of Discharge Planning is an Essential Component in Total Knee Arthroplasty.Knee surgery & related research · 2022Article
- [Results and lessons learned in fast-track arthroplasty].Der Orthopade · 2022Review
- Rapid rise in prevalence of knee replacements and decrease in revision burden over past 3 decades in Finland: a register-based analysis.Acta orthopaedica · 2022Article
- Impact of enhanced recovery pathways on safety and efficacy of hip and knee arthroplasty: A systematic review and meta-analysis.World journal of orthopedics · 2022Article
- Low incidence of clinically relevant bleeding complications after fast-track arthroplasty: a register study of 8,511 arthroplasties.Acta orthopaedica · 2022Article
- Improvement in fast-track hip and knee arthroplasty: a prospective multicentre study of 36,935 procedures from 2010 to 2017.Scientific reports · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Fast-tracking shortens the length of the primary treatment period (length of stay, LOS) after total knee replacement (TKR). We evaluated the influence of the fast-track concept on the length of uninterrupted institutional care (LUIC) and other outcomes after TKR. Patients and methods - 4,256 TKRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast track (Hospital A) and non-fast track (Hospitals B, C and D). We analyzed length of uninterrupted institutional care (LUIC), LOS, discharge destination, readmission, revision, manipulation under anesthesia (MUA) and mortality rate in each hospital. We compared these outcomes for TKRs performed in Hospital A before and after fast-track implementation and we also compared Hospital A outcomes with the corresponding outcomes for the other 3 hospitals. Results - After fast-track implementation, median LOS in Hospital A fell from 5 to 3 days (p < 0.001) and (median) LUIC from 7 to 3 (p < 0.001) days. These reductions in LOS and LUIC were accompanied by an increase in the discharge rate to home (p = 0.01). Fast-tracking in Hospital A led to no increase in 14- and 42-day readmissions, MUA, revision or mortality compared with the rates before fast-tracking, or with those in the other hospitals. Of the 4 hospitals, LOS and LUIC were most reduced in Hospital A. Interpretation - A fast-track protocol reduces LUIC and LOS after TKR without increasing readmission, complication or revision rates.
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