Entity

Time filter

Source Type

Holstebro, Denmark

Hansen T.B.,The Orthopaedic Research Unit | Bredtoft H.K.,Regional Hospital Holstebro | Larsen K.,Regional Hospital Holstebro
Danish Medical Journal | Year: 2012

INTRODUCTION: The aim of this study was to investigate if screening and optimization of risk patients combined with a motivational conversation is effective in reducing complications in patients scheduled for a fast-track hip and knee arthroplasty. MATERIAL AND METHODS: We included 78 patients in the intervention group and 54 patients in a control group before the intervention. In the intervention group, all patients participated in a motivational conversation during which they were screened, and a nurse addressed all risk areas in patients at risk. The primary outcome was unintended patient paths, defined as a path where the discharge criteria were not reached within five days (minor complications), major postoperative complications, readmissions or death within three months postoperatively. RESULTS: A total of 35 (45%) of the 78 patients in the intervention group were classified as being at risk in one or more areas after the screening. The number of unintended patient paths was significantly reduced from 19 (35%) in the control group to 14 (18%) in the intervention group (p = 0.025). CONCLUSIONS: Preoperative physical optimization of patients who are at risk of following an unintentional path is effective in patients scheduled for fast-track hip and knee arthroplasty. FUNDING: not relevant. TRIAL REGISTRATION: not relevant. Source


Larsen K.,The Orthopaedic Research Unit | Larsen K.,Lundbeck | Hansen T.B.,The Orthopaedic Research Unit | Hansen T.B.,Lundbeck | And 4 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy | Year: 2012

Purpose: The purpose of this study was to describe patient-related functional outcomes after fast-track total knee arthroplasty and unicompartmental knee arthroplasty. Furthermore, we wanted to assess physical areas where an additional need for rehabilitation could be identified, and finally, we wanted to describe the association between physical function, health-related quality-of-life (HRQOL) and patient satisfaction. Methods: The study consisted of 211 consecutive fast-track patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one outpatient visit. The patients filled in 3 questionnaires (EQ-5D, SF36 and a disease-specific questionnaire) at 2 time points before the operation and 2 time points after the operation. The observed results were compared to normative population data for EQ-5D and SF36. Results: Four months after the operation, the patients had reached a HRQOL level of 0. 82 (SD 0. 15), which was lower than the background population norm of 0. 85 (n. s.), whereas it equaled the population norm at 12 months (n. s.). For SF36, physical function was 62. 8 (SD 23. 0) at 4 months and 66. 2 (SD 24. 1) at 12 months, which was lower than the background population norm of 75.0 (P > 0.01). No or mild pain and good function ability were associated with high HRQOL and patient satisfaction at follow-up. Conclusions: There seems to be an additional need for postoperative rehabilitation after fast-track total knee arthroplasty and unicompartmental knee arthroplasty regarding early functional outcome. No or mild pain and good functional abilities at 4 months are associated with high HRQOL and patient satisfaction at 4- and 12-month follow-up. Level of evidence: II. © 2012 Springer-Verlag. Source


Larsen K.,The Orthopaedic Research Unit | Larsen K.,Lundbeck | Hansen T.B.,The Orthopaedic Research Unit | Hansen T.B.,Lundbeck | And 4 more authors.
Health and Quality of Life Outcomes | Year: 2010

Background: A fast-track intervention with a short preoperative optimization period and short postoperative hospitalization has a potential for reduced convalescence and thereby a reduced need for postoperative rehabilitation. The purpose of this study was to describe patient-related outcomes, the need for additional rehabilitation after a fast-track total hip arthroplasty (THA), and the association between generic and disease specific outcomes.Methods: The study consisted of 196 consecutive patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one in-patient visit. The patients filled in 3 questionnaires to measure health-related quality-of-life (HRQOL) and hip specific function (EQ-5 D, SF36, and Harris Hip Score (HHS)) at 2 time points pre- and 2 time points postoperatively. The observed results were compared to normative population data for EQ-5 D, SF36, and HHS.Results: 3-months postoperatively patients had reached a HRQOL level of 0.84 (SD, 0.14), which was similar to the population norm (P = 0.33), whereas they exceeded the population norm at 12 months postoperatively (P < 0.01). For SF36, physical function (PF) was 67.8 (SD, 19.1) 3 months postoperatively, which was lower than the population norm (P < 0.01). PF was similar to population norm 12-months postoperatively (P = 0.35). For HHS, patients never reached the population norm within 12 months postoperatively. Generic and disease specific outcomes were strongly associated.Conclusions: If HRQOL is considered the primary outcome after THA, the need for additional postoperative rehabilitation for all THA patients following a fast-track intervention is questionable. However, a pre- or early postoperative physical intervention seems relevant if the PF of the population norm should be reached at 3 months. If disease specific outcome is considered the primary outcome after fast-track THA, clear goals for the rehabilitation must be established before patient selection, intervention type and timing of intervention can be made. © 2010 Larsen et al; licensee BioMed Central Ltd. Source


Madsen M.,The Orthopaedic Research Unit | Larsen K.,The Orthopaedic Research Unit | Larsen K.,Lundbeck | Kirkegard Madsen I.,Holstebro Regional Hospital | And 3 more authors.
Danish Medical Journal | Year: 2013

INTRODUCTION: This study aimed to test whether groupbased rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA). MATERIAL AND METHODS: We allocated 80 participants undergoing primary TKA to either group-based rehabilitation or individual, supervised home-training (40 participants in each group). The group-based rehabilitation consisted of 12 outpatient visits during six weeks including strength and endurance exercises, education and self-management combined with home exercises. The primary outcome was Oxford Knee Score; secondary outcomes were EuroQoL-5 Dimensions Qol and Physical Function of the Medical Outcomes Short Form 36. Tertiary outcomes were pain, knee range of motion, tandem test, Leg Extensor Power, 10-m walking test, 30-sec. and five-times sit-to-stand. Outcomes were assessed four weeks, three months and six months after surgery. In addition, the questionnaires were completed before surgery. RESULTS: We found no difference in gain of function or quality of life between the two groups at three and six months follow-up. CONCLUSION: Individual, supervised home-training and group-based rehabilitation programmes improved patients' quality of life and physical function equally six months after TKA. Source

Discover hidden collaborations