Patient Education Before Hip or Knee Arthroplasty Lowers Length of Stay

https://doi.org/10.1016/j.arth.2009.03.012Get rights and content

Abstract

From April 2006 to May 2007, 261 patients undergoing primary unilateral total hip arthroplasty or total knee arthroplasty were offered voluntary participation in a one-on-one preoperative educational program. Length of stay (LOS) and inpatient data were monitored and recorded, prospectively. Education participants enjoyed a significantly shorter LOS than nonparticipants for both total hip arthroplasty (3.1 ± 0.8 days vs 3.9 ± 1.4 days; P = .0001) and total knee arthroplasty (3.1 ± 0.9 days vs 4.1 ± 1.9 days; P = .001).

Section snippets

Preoperative Education

Patients undergoing primary unilateral THA or TKA between April 2006 (the educational program's inaugural month) and May 2007 were eligible for voluntary participation in our Center for Hip and Knee Replacement (CHKR) Preoperative Patient Education Program. Patients undergoing revision procedures, having undergone previous hip or knee arthroplasty, bilateral THA or TKA, or other forms of arthroplasty (ie, hip resurfacing, unicondylar knee arthroplasty), were excluded. Performance of the study

Results

From April 2006 to May 2007, 261 eligible patients (male, 170/261) were successfully contacted and offered voluntary participation in the CHKR Preoperative Patient Education Program. Of the 261 patients, 168 (64%) chose to participate, whereas 93 (36%) did not. Of the 93 who did not participate, reasons included scheduling too close to the DOS; inability obtain contact with the patient, which included no return phone calls from the patient; and simple refusal in participation in the program.

Discussion

Despite disparate results from other similar published reports about the effect of TJA preoperative education 10, 11, 19, 20, 21, 23, our results indicate that preoperative education does indeed significantly reduce the LOS, by approximately 1.0 day, for those undergoing THA and TKA procedures.

Our results coincided with a Canadian report by Crowe and Henderson [14] in 2003, which also noted a significant decrease in primary THA and TKA LOS with preoperative education in a prospective randomized

Acknowledgments

The authors acknowledge New York-Presbyterian Hospital for the responsiveness and foresight of its administration (Robert Kelly, MD, senior vice president, chief operating officer, and chief medical officer of the Columbia campus) for supporting funding for this consumer-oriented and quality-of-care enhancing patient educational program and to Financial Analyst, Troy Trejo in the Financial Planning Division of the New York-Presbyterian Health care Medical Centers office, for his help in

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    No benefits or funds were received in support of the study.

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