IMPACT OF EARLY WITHDRAWAL FROM BED IN TOTAL KNEE ARTHROPLASTY

Abstract

Introduction: Osteoarthrosis is a progressive inflammatory and degenerative disease that causes pain, functional disability and immobility. In case of failure of conservative therapy, Knee Arthroplasty (TKA) is indicated. Objectives: Impact Analysis of patient's early withdrawal from postoperative bed (PO) and to identify which motives delay this process. Methodology: Prospective and experimental study with patients submitted to a protocol of early mobilization post TKA, from July 2014 to March 2015. For the statistical analysis were used the tests of Fischer and T of unpaired student. The significance level was 5% (p <0.05) and the data were presented as average and standard deviation. Results: Sample of 30 patients, age of 67.5±7.4 years, 80% female, osteoarthrosis as etiology for TKA. The NS group (did not leave the bed in 1^st PO) presented more pain (PO immediate 6.4±4.1 vs 3.3±3.5, p=0.03; 1^st PO 7.1±3.2 vs 3.8±3.5, p=0.01; 2^nd PO 5.7±3.2 vs 2.1±2.4, p=0.00; 3^rd PO 4.6±2.8 vs 1.7±2.4 of SS group, p=0.003) than SS group (left the bed in 1^st PO). SS group followed the protocol more frequently (p=0.003). The average hospital stay was higher in the NS group (5.0±2.5 vs 2.8±0.8, p=0.00) and the amount of Physiotherapy appointments was higher in the NS group (9.5±5.7 vs 4.7±1.7, p=0.00). The most frequent cause of impediment for leaving the bed in the 1^st P.O. was non medical release (62%), followed by indisposition, lack of prescription of physiotherapy and pain.  Conclusion: The protocol was beneficial regarding to pain, functional capacity and period of Hospital stay, which could reduce hospital costs.