Optimization of the Patient Undergoing Total Knee Arthroplasty – The Rapid Recovery Program

Introduction

There is traditionally an unnecessary “medicalization” of the orthopedic patient undergoing total knee arthroplasty. Such procedures have commonly been performed under general anesthetic with difficulties in managing postoperative analgesia requirements resulting in slow mobilization and recovery. In-patient stays of 2 weeks are commonplace and care is often disjointed with limited interaction between the different groups of health care providers.

Abstract

There is traditionally an unnecessary “medicalization” of the orthopedic patient undergoing total knee arthroplasty. Such procedures are commonly performed under general anesthetic with difficulties in managing postoperative analgesia requirements resulting in slow mobilization and recovery. In-patient stays of 2 weeks are commonplace and care is often disjointed with limited interaction between the different groups of health care providers. Changing demographics and an ever-increasing demand for joint replacement dictate that the processes be streamlined to maximize efficiency. Rapid Recovery is an evidence-based means of providing the best possible patient care, while at the same time optimizing the use of resources. It promotes patient centered care with a focus on patient education and prehabilitation. The preoperative, intraoperative, and postoperative stages of Rapid Recovery are described. The significant reduction in the length of in-patient stay, the considerable cost savings, and the low complication rates are discussed as well as the favorable patient satisfaction scores. Rapid Recovery should now be thought of as the gold standard for the treatment of all patients undergoing hip and knee replacement.

Keywords

Rapid Recovery, fast track surgery, enhanced recovery knee, hip, arthroplasty, LIA