Clinical results before and after implementation of a Fast - Track protocol for 507 patients who underwent total knee arthroplasty surgery: A retrospective, observational study.

Abstract

Background: Total knee arthroplasty (TKA) is a common surgical procedure for patients with advanced osteoarthritis. !is study aimed to assess the e'ects of using versus not using a fast-track protocol, including a new mobilization device called Flexet. Methods: !is is a retrospective comparative study. Two groups were formed with a total of 507 TKA patients. 283 were treated in 2010 with a standard program (S group) and 224 with a fast-track protocol (FT group) in 2016. !e variables studied were active knee #exion and extension, length of stay, and time to autonomous gait. Results: Study groups were comparable. !e mean time from surgery to autonomous gait was shorter for the FT group (4.43 hours, SD = 2.11) than for the S group (59.95 hours, SD = 16.59) (p < 0.001). Mean stay for the FT group was 2.36 nights (SD = 1.81) and 6.20 nights (SD = 1.52) for the S group (p < 0.001). Mean active #exion at hospital discharge was 89.33º (SD = 7.45) in the FT group versus 84.10º (SD = 9.01) in the S group. !e mean active extension was: -5.37º (SD = 2.49) in the FT group versus -8.60º (SD = 3.98) in the S group, (p<0.001). Conclusion: Patients in the FT group showed more signi$cant improvements (i.e., shorter length of stay, shorter time to autonomous gait, and larger active ROM in #exion and extension). However, the exact role of the Flexet device is still to be determined. Keywords: Total Knee Arthroplasty, Fast-Track, Rapid-Recovery, ROM, early mobilization, active physiotherapy.