Early follow-up after TKA with rapid recovery, diary-study. A pilot study.

Historically, the length of hospital stay after primary Total Hip Arthroplasty
(THA) and primary Total Knee Arthroplasty (TKA) exceeded several weeks, with a
subsequent period of bed rest during hospitalization. During the last decade,
there has been a continued interest in reducing the length of hospital stay to
a few days. Moreover rapid recovery protocols have been introduced worldwide
after elective primary THA and TKA. Various studies have shown these protocols
have reduced the length of hospital stay and the length of rehabilitation
following primary THA and TKA. Also a decrease in complication rate and
readmission rate have been described.
These rapid recovery protocols are based on analysis of clinical care
principles and pain management in combination with the revision of
organizational factors, allowing an optimized perioperative period that is safe
for the patient.
In Reinier de Graaf Hospital (RdGG), the introduction of the rapid recovery
protocol for primary THA and TKA started in 2009 and was introduced in several
phases. In February 2011 all phases of this rapid recovery protocol for primary
THA were introduced. The introduction of the rapid recovery protocol in our
hospital indeed yielded a shorter length of hospital stay without an increase
of complications, readmissions and reoperations after primary THA and TKA.
Most studies on rapid recovery focused on optimizing the postoperative phase
during hospital stay. However, little is known about the early postoperative
phase after discharge from the hospital. Studies on outcome after hospital
discharge mostly evaluate function after three to six month little is known of
the first 6 weeks after discharge.
The focus of this study will be on problems regarding pain, rehabilitation,
physical functioning, medication, quality of life and complications of patients
after TKA surgery with rapid recovery during the first 6 weeks after discharge
from the hospital.

This study investigate the problems which patients experience after hospital
discharge after TKA surgery during the first six weeks post-operative. We will
use the outcome of this study to optimize the first six weeks after hospital
discharge.
The focus of this study will be on problems regarding pain, rehabilitation,
physical functioning, medication, quality of life and complications.

This a prospective, observational trail in which 30 patients are asked to
complete questionnaires on daily basis the first 6 weeks after primary TKA
surgery. We will call patients to remind and to motivate in the first 2 weeks 2
times and in the 3rd and 5th week one time by the research nurse. The completed
questionnaire will be returned to the surgeon at standard 6 weeks control.

Patients will be asked to complete questionnaires on daily basis. This will
take 5 minuts a day. During this 2 weeks the investigator / research nurse will
call two times a week to motivate to complete the questionnaires.
During the 3rd to 6th week patients will be asked daily basis. This will take 4
minutes a day. In the 3rd and 5th week the investigator / research nurse will
call to motivate.
Total effort for patients will be 3,5 hours during the six weeks.

There will be no risk for patients in this study.