RAPID REHABILITATION ARTHROPLASTY PROTOCOL IN SAUDI ARABIA : REDUCING HOSPITAL STAY

Background: Fewstudies havefocused on patient characteristics that influence lengthof stay in fast-track total hip (THR) and kneearthroplasty (TKR). The aim of this retrospective studywas to identify patient characteristics associated withlength of stay and patient satisfaction after total hip and kneereplacement surgery.

Patients and Methods: Between January 2023 toJune 2023,62 TKR patientswith a mean age of 67.6±11.8years and 12 THR with a mean age of 53.8±17.0wereadmitted at ourspecialized fast-track joint replacement unit. A single fellowship-trained surgeon operated on all patients.We did interviews with the patients before the operation and 6 weeks after surgery to collect pre and post-operative Oxford knee scores for TKRs and pre and post-operation Oxford hip scores for THRs.

Results: A total of 62 TKR patients and 12 THR patients enrolled in our study. The mean age of TKR patients was 67.6±11.8years, and 44 subjects (71%) were female. The mean age of THR patients was 53.8 years±17.0, and 8 subjects (66.7%) were male. Mean of BMI was reported as 33.9±6.1 in TKR patients and 30.9±6.1 in THR patients. The Mean of ASA was 2.2±0.6 in TKR patients and 1.9±0.5 in THR patients. Length of stay in hospital was documented as 3.9±0.7 in TKR patients and 4.3±0.6 in THR patients.Most patients of have osteoarthritis, while rheumatoid arthritis was reported in TKR (n=3, 4.8%) and THR (n=1, 8.3%) patients. A significant length of stay was reported with increasing BMI and ASA score in TKR and THR patients. 

In Conclusion: The most common diagnosis for surgery was osteoarthritis, which usually affected womens right sides. Annual increases in the number of surgeries have been made, and Oxford ratings indicate that they have a very high success rate. The characteristics linked with a prolonged duration of stay after total hip or knee arthroplasty are significantly influenced by the case mix, particularly the BMI and ASA before surgery.

背景：目前鲜有研究关注影响快速流程全髋关节置换术（total hip replacement, THR）与全膝关节置换术（total knee arthroplasty, TKR）患者住院时长的患者特征。本回顾性研究旨在明确全髋与膝关节置换术后，与患者住院时长及患者满意度相关的患者特征。

患者与方法：2023年1月至2023年6月期间，本专科快速流程关节置换病房共收治62例全膝关节置换术（TKR）患者，平均年龄为67.6±11.8岁；12例全髋关节置换术（THR）患者，平均年龄为53.8±17.0岁。所有手术均由同一名接受过专科进修培训的外科医师完成。我们于术前及术后6周对患者进行访谈，收集全膝关节置换术患者的术前、术后牛津膝关节评分，以及全髋关节置换术患者的术前、术后牛津髋关节评分。

结果：本研究共纳入62例全膝关节置换术患者与12例全髋关节置换术患者。全膝关节置换术患者的平均年龄为67.6±11.8岁，其中44例（71%）为女性；全髋关节置换术患者的平均年龄为53.8±17.0岁，其中8例（66.7%）为男性。全膝关节置换术患者的平均体重指数（Body Mass Index, BMI）为33.9±6.1，全髋关节置换术患者为30.9±6.1。全膝关节置换术患者的平均美国麻醉医师协会（American Society of Anesthesiologists, ASA）评分为2.2±0.6，全髋关节置换术患者为1.9±0.5。全膝关节置换术患者的平均住院时长为3.9±0.7天，全髋关节置换术患者为4.3±0.6天。大多数患者的术前诊断为骨关节炎，全膝关节置换术患者中3例（4.8%）为类风湿关节炎，全髋关节置换术患者中1例（8.3%）为类风湿关节炎。全膝关节与全髋关节置换术患者中，住院时长随体重指数与美国麻醉医师协会评分升高而显著延长。

结论：本研究中最常见的手术指征为骨关节炎，且此类病症更常见于女性患者。手术量呈逐年递增趋势，牛津评分结果显示此类手术的成功率极高。全髋或膝关节置换术后住院时长延长相关的患者特征，受病例组合的显著影响，尤以术前体重指数与美国麻醉医师协会评分为著。