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Clinical Trial
. 1999 Jan 18;170(2):59-62.
doi: 10.5694/j.1326-5377.1999.tb126882.x.

Clinical pathways in hip and knee arthroplasty: a prospective randomised controlled study

M M Dowsey  1 , M L Kilgour, N M Santamaria, P F Choong
Affiliations
Clinical Trial

Clinical pathways in hip and knee arthroplasty: a prospective randomised controlled study

M M Dowsey et al. Med J Aust. .

Abstract

Objective: To ascertain the effectiveness of clinical pathways for improving patient outcomes and decreasing lengths of stay after hip and knee arthroplasty.

Design and setting: Twelve-month randomised prospective trial comparing patients treated through a clinical pathway with those treated by an established standard of care at a single tertiary referral university hospital.

Participants: 163 patients (56 men and 107 women; mean age, 66 years) undergoing primary hip or knee arthroplasty, and randomly allocated to the clinical pathway (92 patients) and the control group (71 patients).

Main outcome measures: Time to sitting out of bed and walking; rates of complications and readmissions; match to planned discharge destination; and length of hospital stay.

Results: Clinical pathway patients had a shorter mean length of stay (P = 0.011), earlier ambulation (P = 0.001), a lower readmission rate (P = 0.06) and closer matching of discharge destination. There were beneficial effects of attending patient seminars and preadmission clinics for both pathway and control patients.

Conclusion: Clinical pathway is an effective method of improving patient outcomes and decreasing length of stay following hip and knee arthroplasty.

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Comment in

  • Clinical pathways.
    Kitchiner DJ, Bundred PE. Kitchiner DJ, et al. Med J Aust. 1999 Jan 18;170(2):54-5. doi: 10.5694/j.1326-5377.1999.tb126880.x. Med J Aust. 1999. PMID: 10026682 Review. No abstract available.
  • Clinical pathways.
    Caplan G, Brown A. Caplan G, et al. Med J Aust. 1999 Jun 7;170(11):568. doi: 10.5694/j.1326-5377.1999.tb127896.x. Med J Aust. 1999. PMID: 10397057 No abstract available.
  • Readmission as an outcome variable.
    Ibrahim JE, Majoor JW, Cicuttnni F, McNeil JJ. Ibrahim JE, et al. Med J Aust. 1999 Aug 16;171(4):218-9. doi: 10.5694/j.1326-5377.1999.tb123609.x. Med J Aust. 1999. PMID: 10494241 No abstract available.

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