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Total Knee Replacement: In and Out in a Day

Gone are the days of long stays in the hospital for knee surgery. More and more studies are reporting good results with minimally invasive surgery (MIS) for total knee replacement (TKR). In this report one surgeon replaces the knee joint in 50 patients on an outpatient basis.

The patients are carefully chosen. They must be in good health. They can't be overweight or obese. Only a small incision was used. All but two patients went home the same day. There were no problems linked to early discharge.

What do doctors credit this advance in treatment to? They say new critical pathways are the answer. What does that mean?

  • Classes by nurses and physical therapists to prepare patients before
    the operation.
  • Improved ways of giving patients anesthesia.
  • Better pain management after the operation.
  • A special rehab program five to six hours after surgery.

    The authors of this study aren't sure if one, two, or all of the steps in the critical pathway make the difference. Does MIS have to be done in a specialized clinic or can this be done in a community practice setting? They suggest more studies in the future to answer these and other questions before MIS TKR are done on everyone.

    • Reference: 

    Richard A. Berger, MD, et al. Outpatient Total Knee Arthroplasty With a Minimally Invasive Technique. In The Journal of Arthroplasty. October 2005. Vol. 20. No. 7. Suppl. 3. Pp. 33-38.

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