Clinical pathways in total knee arthroplasty: A New Zealand experience

JM Pennington, DPG Jones, S McIntyre
Department of Orthopaedic Surgery, Dunedin Hospital, Dunedin, New Zealand

PURPOSE. To ascertain the effects of a clinical pathway in our institution.

METHODS. This retrospective and comparative study was performed on all patients undergoing total knee arthroplasty over a 5-year period. This period covered the 30 months prior to the introduction of the pathway (group 1), and the 30 months following its introduction (group 2).

RESULTS. There was a significant reduction in the duration of hospital stay of group 2 patients (p<0.0001), with 62.8% of these patients staying less than 8 postoperative days. There was a reduction in the number of patients with thromboembolic complications (p<0.05) and no increase in overall complications or readmission rate. There was a trend to increased use of rehabilitation services among group 2 patients.

CONCLUSION. Clinical pathway implementation resulted in a significant reduction in the length of stay, and achieved a more efficient management of hospitalised patients without compromising outcome.