Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 Mar 5;8(1):17.
doi: 10.1186/s40779-021-00310-x.

Benefits of early ambulation within 24 h after total knee arthroplasty: a multicenter retrospective cohort study in China

Yi-Ting Lei  1   2 , Jin-Wei Xie  2 , Qiang Huang  2 , Wei Huang  3 , Fu-Xing Pei  4
Affiliations
Multicenter Study

Benefits of early ambulation within 24 h after total knee arthroplasty: a multicenter retrospective cohort study in China

Yi-Ting Lei et al. Mil Med Res. .

Abstract

Background: Postoperative care has been evolving since the concept of enhanced recovery after surgery (ERAS) was introduced in China. This study aimed to evaluate the effects of early ambulation within 24 h after unilateral total knee arthroplasty (TKA) on postoperative rehabilitation and costs in a Chinese population.

Methods: This cohort study of patients with knee osteoarthritis who had undergone TKA at 24 large teaching hospitals between January 2014 and November 2016 involved 2687 patients who began ambulating within 24 h (Group A) and 3761 who began ambulating later than 24 h (Group B). The outcome measurements, such as length of stay (LOS), total hospitalization costs, dynamic pain level, knee flexion range of motion (ROM), results of the 12-Item Short Form Survey (SF-12), incidence of thromboembolic events and other complications, were recorded and compared.

Results: The early ambulation group (Group A) had a shorter LOS and lower hospitalization costs and pain levels than the late ambulation group (Group B). There was a favorable effect in enhancing ROM for patients in Group A compared with patients in Group B. In Group A, patients had significantly higher postoperative SF-12 scores than those in Group B. The incidence of deep venous thrombosis (DVT) and pulmonary infection was significantly lower in Group A than in Group B. The incidence of pulmonary embolism (PE) and other complications did not differ between the two groups.

Conclusion: Early ambulation within 24 h after TKA was associated with reduced LOS, improved knee function, lower hospitalization costs and lower incidence of DVT and pulmonary infection in the Chinese population.

Keywords: Costs; Deep venous thrombosis; Early ambulation; Length of stay; Total knee arthroplasty.

PubMed Disclaimer

Conflict of interest statement

All authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of the patients showing the study design
See this image and copyright information in PMC

References

    1. Xie J, Ma J, Yao H, Yue C, Pei F. Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss after primary total knee arthroplasty without tourniquet: a randomized clinical trial. J Arthroplast. 2016;31(11):2458–2464. doi: 10.1016/j.arth.2016.04.034. - DOI - PubMed
    1. Frassanito L, Vergari A, Nestorini R, Cerulli G, Placella G, Pace V, et al. Enhanced recovery after surgery (ERAS) in hip and knee replacement surgery: description of a multidisciplinary program to improve management of the patients undergoing major orthopedic surgery. Musculoskelet Surg. 2019;104(1):87–92. doi: 10.1007/s12306-019-00603-4. - DOI - PubMed
    1. Petersen PB, Kehlet H, Jorgensen CC. Safety of in-hospital only thromboprophylaxis after fast-track total hip and knee arthroplasty: a prospective follow-up study in 17, 582 procedures. Thromb Haemost. 2018;118(12):2152–2161. doi: 10.1055/s-0038-1675641. - DOI - PubMed
    1. Berend KR, Lombardi AV, Jr, Mallory TH. Rapid recovery protocol for peri-operative care of total hip and total knee arthroplasty patients. Surg Technol Int. 2004;13:239–247. - PubMed
    1. Malviya A, Martin K, Harper I, Muller SD, Emmerson KP, Partington PF, et al. Enhanced recovery program for hip and knee replacement reduces death rate. Acta Orthop. 2011;82(5):577–581. doi: 10.3109/17453674.2011.618911. - DOI - PMC - PubMed

Publication types