Yoeri Bemelmans

Chapter 6 78 A case-controlled pilot study was performed over the first 20 consecutive cases operated in an OS pathway, these results were compared with a control group operated in a convential enhanced recovery pathway (RR). We investigated whether patients could be discharged on the day of surgery as scheduled, resulting in comparable or better outcome by means of adverse events (AE’s) and patient reported outcome measurements (PROMS). Materials andMethods All patients were informed and consented to providing data for anonymous use. Between December 2013 and June 2014, 34 patients with indication for primary UKA [29] were potential candidates to participate in the OS pathway. Patients with severe cardiologic, pulmonary and/or internal diseaseswere excluded. These patients required anovernight stay for additional treatment pre-, peri- and postoperative for adjustment of medication (e.g. diabetes mellitus (DM), bridging anticoagulation). Patients who were not able to understand and complete the procedure due to cognitive dysfunction, fear to follow the outpatient procedure, or those who could not be discharged to their home environment were also excluded (Figure 1). Twenty patients were eligible candidates to participate in the OS pathway. If patients were excluded from the OS pathway, they were treated in the RR pathway as the standard pathway in our department for hip- and knee arthroplasty. Figure 1. Flowchart of potential and included patients for the OS pathway. Initiated for UKA n=34 Included in the OS pathway n=20 Excluded • Fear (n=2) • Home environment (n=1) • Severe cardiologic diseases (n=1) • Severe internal diseases (n=4) • Participated in another trial (n=6) Pathways Within OS, a personal coach (a relative) indirectly reduces the workload on the ward, by involvement as much as possible, to inspire, correct, and support the patient during inpatient and outpatient for the first 48 hours (hrs) postoperative.