Total knee arthroplasty (TKA) has been performed since the 60 YEARS and has significantly improved the quality of life of patients suffering from osteoarthritis of the knee. Recent trends show that patients undergo surgery at a younger age. Furthermore, they want to be able to return to their daily activities and work as soon as possible. Due to multimodal analgesia, and improvements in wound care, physical therapy, operative techniques the length of stay (LOS) has decreased to such an extent that 75% of patients remain in hospital for 3 days or less after TKA. A combination of these measures has increasingly been used in fast-track protocols. The first fast-track protocols reduced LOS from an average of 2 weeks to less than 1 week.
A fast-track protocol usually contains several parts that are aimed at improving outcome.
1. Fast-track protocols could reduce costs because of a reduction in LOS. If all patients left the hospital 1–2 days earlier than usual, regular costs of hospital admittance would decrease.
2. Fast-track protocols could result in better cost-effectiveness because patients that have better function when discharged from hospital would require less pain medication, a lower number of physiotherapy treatments and a lower number of days spent in rehabilitation centres, and they would be able to return to work sooner.
1. Comorbidities can hamper the patient to be included in this protocol
2. Patients pain threshold is different. Hence, some patients may have a poor satisfaction score and may be uncomfortable.