Practice protocols and advantages of patients with out-pati̇ent knee prosthesis

INTRODUCTION AND PURPOSE: Gonarthrosis or osteoarthritis of the knee is a condition leading to pain, stiffness, knee deformity, muscle weakness and eventually a decrease in quality of life. It is one of the main reasons causing disorder and disability in people over 55 years old and it is an significant public health problem. Therefore, the treatment of that condition is becoming increasingly important as it also causes social and financial loses, and needing to take precautions to avoid further loses. Due to increased life expectancy, span and contributing factors such as obesity, it has been diagnosed more and more in recent years and it is expected to see this increase further. Total knee arthroplasty (TKA) is the treatment of choice in advanced knee arthritis. In the current study, we aimed to compare the TKAs with conventional hospital admission and the ones with day-case admission in terms of pain, functional scores, angle measurements and the total costs. MATERIALS AND METHODS: In our study, we looked into the patients who presented with primer knee osteoarthritis and had total knee arthroplasty at Sakarya University Orthopaedic and Traumatology department between 1st of January and 31st of December 2019. The included 76 patients were divided into two groups; the first group (38 patients) had TKA as day-case and the second group (38 patients) were admitted to the hospital as normal for their TKA operations. We compared their age, weight, height, BMI and hospital costs. Also, the relationships between the angle measurements on the x-ray and, KSS and VAS were compared. FİNDİNGS: The results showed no statistical difference between x-ray measurements and functional scores. However, there was a significant difference in the relationship between coronal alignment and KSS scores at postoperative 6th week between the two groups (P<0.013). Similarly, there was a significant statistical difference in the total costs of TKA between the groups as well as their hospital stay (p<0.001). RESULT: In conclusion, as there was no difference between two groups regarding functional scores, postoperative short-tem complication rate, x-ray measurements and alignment, and the day-case group has better cost effectiveness and less problem with the number of hospital beds. This can be a good alternative to the orthopaedic surgeons who work at a busy hospital. Key words: Osteoarthritis, gonarthrosis, total knee arthroplasty, day-case surgery, arthroplasty cost.