Recovery After Partial Knee Arthroplasty and Daycare Surgery

Abstract

UKA is a minimally invasive procedure that allows for safe, efficient care with fewer perioperative complications, leading to higher patient satisfaction and improved cost-effectiveness. The philosophy of marginal gains has enabled day case arthroplasty to become feasible. Patients are assessed for suitability for daycase surgery, and any patients at risk of unstable conditions are excluded from the day of surgery discharge pathway. Patients are informed about the perioperative plan and given consistent advice to prepare for same day discharge. Anaesthetic of choice is GA, and premedication is intravenous. Antibiotics are administered before induction. Surgery is performed in the supine position with a thigh support and a high thigh tourniquet using Oxford microplasty instrumentation. Post-operatively, patients are allowed to eat and drink freely, receive rescue analgesia, and are mobilised fully weight bearing with crutches. Patients are provided with post-operative analgesics, laxatives and anti-emetics, have direct access to a 24-hour telephone helpline service, are admitted overnight, receive same post-operative instructions, return to UKA clinic on fifth post-operative day for physiotherapy, and are reviewed at 6 weeks. Introducing an effective outpatient arthroplasty protocol requires a multidisciplinary approach, with a consistent team message and good patient education to achieve successful same day discharge. Financial savings from a safe and effective day of surgery discharge pathway are considerable.