单髁关节置换术日间手术可行性分析——一项巢式病例对照研究

Abstract
Figure/Table
References
Related Citation (4)

Download: PDF (977 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the feasibility of the day surgery model of joint replacement by retrospectively analyzing the perioperative management and early regression of patients undergoing unicompartmental knee arthroplasty(UKA) in the day surgery model and the conventional inpatient model. Methods Patients receiving UKA day surgery under general anesthesia in the Fourth Medical Center of PLA General Hospital from May 2023 to September 2024 were selected as the day surgery group. Based on the patients' gender, age and other information, they were matched with concurrent hospitalized general anesthesia UKA patients according to 1:3 as the conventional surgery group. The basic condition of the patients, perioperative anesthesia management, length of stay, hospitalization cost, postoperative complications, and readmission rate were compared between the two groups. Results A total of 224 cases were included (56 cases in the day surgery group and 168 cases in the conventional surgery group). There were no statistically significant differences in the basic condition of the patients, ASA classification, or preoperative comorbidities between the groups (P>0.05); there were also no statistically significant differences in the intraoperative patients' mean arterial pressure, heart rate, anesthesia drug consumption, intraoperative fluid balance, or operative time between the groups (P>0.05); the patients in the day surgery group had significantly higher rates of preoperative retractile myotubular compared with the conventional surgery group, the preoperative retractor tube block rate was significantly higher in the day surgery group (71.4% vs. 36.9%, P＜0.05); there were no statistically significant differences in the postoperative patients' resting and exercise VAS scores, adverse reactions, or readmission rates (P>0.05); and the average hospital stay was (2.36±1.51)d in the day surgery group compared with (7.14±2.07)d in the conventional surgery group, with statistically significant difference (P＜0.05). There was statistically significant difference in the hospitalization cost [(30 100±7600)yuan vs.(38 500±12 100)yuan, P＜0.05)]. Conclusions The use of laryngeal mask general anesthesia combined with preoperative retractor tube block in patients undergoing unicompartmental arthroplasty is a safe and feasible mode of day surgery.

Key words： day surgery unicompartmental knee arthroplasty perioperative management feasibility

Received: 15 September 2024

ZTFLH:

R687

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIU Lingjing
	LI Mengmeng
	LIU Yang
	SUN Yu
	XIE Qun
	FANG Xiaoyan

Cite this article:

LIU Lingjing,LI Mengmeng,LIU Yang等. Feasibility analysis of day surgery for unicompartmental knee arthroplasty: a nested case-control study[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2025, 36(2): 119-123.

URL:

https://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR https://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2025/V36/I2/119

[1]	Leung Y Y, Ma S, Noviani M, et al. Validation of screening questionnaires for evaluation of knee osteoarthritis prevalence in the general population of Singapore [J]. Int J Rheum Dis, 2018, 21(3): 629-638.
[2]	Cho H J, Morey V, Kang J Y, et al. Prevalence and risk factors of spine, shoulder, hand, hip, and knee osteoarthritis in community-dwelling Koreans older than age 65 years [J]. Clin Orthop Relat Res, 2015, 473(10): 3307-3314.
[3]	Murray D W, Parkinson R W. Usage of unicompartmental knee arthroplasty [J]. Bone Joint J, 2018, 100(4): 432-435.
[4]	李金龙, 陵廷贤, 罗泽宇, 等. 中国髋、膝关节置换日间手术的临床应用与发展前景 [J]. 中华骨与关节外科杂志, 2017, 10(1): 76-83.
[5]	Huang A, Ryu J J, Dervin G. Cost savings of outpatient versus standard inpatient total knee arthroplasty [J]. Can J Surg, 2017, 60(1): 57-62.
[6]	Richter D L, Diduch D R. Cost comparison of outpatient versus inpatient unicompartmental knee arthroplasty [J]. Orthop J Sports Med, 2017, 5(3): 2325967117694352.
[7]	Cadariu F, Enache A, Avram M, et al. Day surgery in Romania [J]. Ann Ital Chir, 2017, 88: 567-571.
[8]	康波, 王晋东. 全膝关节置换日间手术的发展现状及开展策略 [J]. 中国组织工程研究, 2021, 25(27): 4408-4414.
[9]	Gondusky J S, Choi L, Khalaf N, et al. Day of surgery discharge after unicompartmental knee arthroplasty: an effective perioperative pathway [J]. J Arthroplasty, 2014, 29(3): 516-519.
[10]	韩超, 祝学梅, 王莹, 等. 日间医疗的规范化发展思考 [J]. 实用医学杂志, 2024, 40(8): 1038-1041.
[11]	Xu J, Cao J Y, Chaggar G S, et al. Comparison of outpatient versus inpatient total hip and knee arthroplasty: a systematic review and meta-analysis of complications [J]. J Orthop, 2020, 17: 38-43.
[12]	Pollock M, Somerville L, Firth A, et al. Outpatient total hip arthroplasty, total knee arthroplasty, and unicompartmental knee arthroplasty: a systematic review of the literature [J]. JBJS Rev, 2016, 4(12): e4.
[13]	Vehmeijer S B W, Husted H, Kehlet H. Outpatient total hip and knee arthroplasty [J]. Acta Orthop, 2018, 89(2): 141-144.
[14]	Berger R A, Kusuma S K, Sanders S A, et al. The feasibility and perioperative complications of outpatient knee arthroplasty [J]. Clin Orthop Relat Res, 2009, 467(6): 1443-1449.
[15]	Bovonratwet P, Ondeck N T, Tyagi V, et al. Outpatient and inpatient unicompartmental knee arthroplasty procedures have similar short-term complication profiles [J]. J Arthroplasty, 2017, 32(10): 2935-2940.
[16]	Cross M B, Berger R. Feasibility and safety of performing outpatient unicompartmental knee arthroplasty [J]. Int Orthop, 2014, 38(2): 443-447.
[17]	Lovald S T, Ong K L, Malkani A L, et al. Complications, mortality, and costs for outpatient and short-stay total knee arthroplasty patients in comparison to standard-stay patients [J]. J Arthroplasty, 2014, 29(3): 510-515.
[18]	刘典琦, 温晓晖, 卢伟杰,等. 收肌管阻滞应用于膝关节置换术后镇痛效果的研究进展 [J]. 中国修复重建外科杂志, 2023, 37(1): 106-114.
[19]	Vora M U, Nicholas T A, Kassel C A, et al. Adductor canal block for knee surgical procedures: review article [J]. J Clin Anesth, 2016, 35: 295-303.