The analysis of the experience gained by the multidisciplinary team during the 5 year work in compliance with the protocol of FAST-TRAC - therapy following the surgical interventions for total endoprosthetics of the hip and knee joints based at the clinic of the federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

This article was designed to report the results of the analysis of the duration of the hospital stay for the patients admitted to a surgical department and its grading taking into consideration the experience of the surgeons. It was shown that the patients operated on by the surgeons having the total period of service below 5 years had the shortest time of hospitalization because many of them presented with concomitant diseases and had to be referred for the further treatment to the more experienced specialists. The questionnaire study carried out within 3-6 weeks after surgery has demonstrated that 31% of the patients treated in compliance with the principles of fast-track therapy remained fully mobile without any restrictions on the distances they were able to cover. The mobility of 53% of the treated patients was confined to their personal apartments and the adjacent courtyards while 31% of them could move only within their apartments. The analysis of the degree of satisfaction of the patients with the medical assistance provided to them showed that 26% of the patients experienced the substantial improvement of their health status, 74% described the improvement as moderate, and 4% appeared unsatisfied with the outcome of the treatment. The analysis of pain sensations in the treated patients revealed the absence of pain in 46% of them whereas 36% estimated the intensity of pain syndrome as 1-5 scores based on the NRS scale whereas 17% estimated pain intensity as being higher than 5 scores. The analysis of the social competence and household skills of the treated patients showed that 38% of them expressed the desire to resume their routine professional activities within 1-2 months after the completion of the treatment, another 34% were prepared to do the same within 2-4 months, and the remaining 27% were ready to work again within 6 months after surgery. Only 2% of the patients did not plan to return to their habitual mode of life. The article expounds the main differences of the concept of fast-track therapy being realized at the clinic of the federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health, from that adopted in analogous foreign healthcare facilities. It is concluded that the modified concept based at our clinic provides a safe and efficient tool for the management of surgical patients.

Full Text

Restricted Access

About the authors

Elizaveta Sergeevna Koneva

Federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

Email: elizaveta.coneva@yandex.ru
cand. med.sci., head of Department of Therapeutic Physical Exercises, Centre of Restorative Medicine and Rehabilitation 125367, Moscow, Russia

A. B Serebryakov

Federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

125367, Moscow, Russia

T. V Shapovalenko

Federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

125367, Moscow, Russia

K. V Lyadov

Federal state autonomous facility “Therapeutic and Rehabilitative Centre”, Russian Ministry of Health

125367, Moscow, Russia

References

  1. Конева Е.С., Серебряков А.Б., Камалова Э.Г., Шаповаленко Т.В., Тарбушкин А.А., Лядов К.В. Анализ выраженности болевого синдрома во время осуществления первой ходьбы у пациентов после операции тотального эндопротезирования суставов нижних конечностей. Травматология и ортопедия России. 2012; (3): 41-4.
  2. Мукуца И.Г., Царенко С.В., Лядов К.В., Конева Е.С., Волошин А.Г. Мультимодальное обезболивание после тотального протезирования тазобедренного сустава. Травматология и ортопедия России. 2012; (4): 72-5.
  3. Конева Е.С. Анализ гемодинамической реакции на проведение ранней ходьбы у пациентов после операций тотального эндопротезирования суставов нижней конечности. Вестник восстановительной медицины. 2012; (5): 41-4.
  4. Конева Е.С., Шаповаленко Т.В., Лядов К.В. Комплексная реабилитация соматически отягощенного пациента после операции одномоментного двустороннего эндопротезирования тазобедренных суставов. Лечебная физкультура и спортивная медицина. 2013; (1): 21-5.
  5. Конева Е.С., Лядов К.В., Шаповаленко Т.В., Серебряков А.Б. Восстановление стереотипа ходьбы с использованием роботизированного устройства у пациентов после операции тотального эндопротезирования коленных суставов. Травматология и ортопедия России. 2013; 2 (68): 31-8.
  6. Конева Е.С., Лядов К.В., Шаповаленко Т.В. Комплексные программы и оценка эффективности ранней послеоперационной реабилитации пациентов после тотального эндопротезирования суставов нижней конечности. Лечебная физкультура и спортивная медицина. 2013; (4): 31-4.
  7. Конева Е.С. Опыт применения комплексной реабилитации у пожилых пациентов с сопутствующей патологией после операции тотального эндопротезировния коленных суставов. Вопр. курортол. 2014; (3): 46-54.
  8. Конева Е.С. Комплексные программы реабилитации пациентов после операций тотального эндопротезирования суставов нижней конечности в раннем послеоперационном периоде. Вестник восстановительной медицины. 2014; 3 (61): 55-65.
  9. Конева Е.С. Эффективность восстановления стереотипа ходьбы у пациентов после эндоротезирования тазобедренного сустава методом аппаратной БОС - видеореконструкции. Вопр. курортол. 2015; (6): 23-9.
  10. Шаповаленко Т.В., Кочорова Л.В., Лядов К.В., Конева Е.С. Современные подходы к организации ранней реабилитации пациентов после эндопротезирования крупных суставов нижних конечностей в условиях ФГБУ «Лечебно-реабилитационный центр Минздравсоцразвития России. Вестник восстановительной медицины. 2012; (4): 32-5.
  11. Husted H. Fast-track hip and knee arthroplasty: clinical and organizational aspects // Acta Orthop. 2012; 83 (Suppl. 346): 1-39.
  12. Ibrahim M.S., Khan M.A., Nizam I., Haddad F.S. Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review. BMC Med. 2013; 11: 37.
  13. Scott C.E., Bugler K.E., Clement N.D., MacDonald D., Howie C.R., Biant L.C. Patient expectations of arthroplasty of the hip and knee. J. Bone Jt Surg. B. 2012; 94: 974-81.
  14. McDonald S., Hetrick S., Green S. Pre-operative education for hip or knee replacement. Cochrane Database Syst Rev. 2004. (1): CD003526.
  15. Husted H., Jensen C.M., Solgaard S., Kehlet H. Reduced length of stay following hip and knee arthroplasty in Denmark 2000-2009: from research to implementation. Arch. Orthop Trauma Surg. 2012; 132: 101-4.
  16. Thienpont E., Lavand’homme P., Kehlet H. The constraints on daycase total knee arthroplasty: the fastest fast track. Bone Joint J. 2015; 97-B (10, Suppl. A): 40-4.
  17. Jourdan C., Poiraudeau S., DescampsRémy Nizard S., Hamadouche M., Anract P., Boisgard S., Galvin M., Ravaud P. et al. Comparison of рatient and surgeon expectations of total Hip arthroplasty. PLoS One. 2012; 7 (1): 30195. (эл. ссылка PMCID: PMC 3260245)
  18. Husted H., Holm G., Jacobsen S. Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients. Acta Orthop. 2008; 79: 168-73.

Statistics

Views

Abstract: 135

PDF (Russian): 1

Cited-by

CrossRef: 1

  1. Grushina T, Teplyakov V. Physiotherapy in early rehabilitation of patients with bone sarcomas after arthroplasty of large bones and joints. Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury. 2020;97(3):53. doi: 10.17116/kurort20209703153

Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2016 Eco-Vector



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies