Fast Track Protocol (Walking) Boosts Arthroplasty Success

According to a Mayo Clinic study, 4.7 million Americans have undergone total knee arthroplasty (TKA) and 2.5 million have had total hip arthroplasty (THA). This has all happened since 1969 when the Mayo Clinic performed the first total hip replacement done in the U.S., followed by the first knee replacement in 1971.

“These numbers underscore the significant positive impact on health and quality of life that total joint replacement surgeries have made since the era of total joint replacement began in 1969, ” said Daniel J. Berry, M.D., of Mayo Clinic Rochester, Minnesota.

There is another factor, called the Fast Track Joint Replacement protocol that has made these surgeries so successful. In the early days of joint replacement the standard treatment called for deep general anesthesia and up to a two weeks stay in the hospital. Most of the pain relief drugs were potent opioids and patients did not leave their beds for days.

Today, following the Fast Track Joint Replacement protocol, doctors use a spinal anesthesia with local infiltration. Their incisions are small. Drains are avoided, compression bandages and cooling are used along with careful monitoring of blood-thinning drugs. Physical therapy begins the same day as the surgery. The Fast Track cuts the time in the hospital, for most patients, to as little as two and a half to three days.

A 2011 study, by researchers at the Hospital for Special Surgery (in New York City) indicated that, “Generally healthy patients who undergo total hip replacement can be Fast Tracked to be discharged in two days compared with the standard three to six days.”

The professional association Reliance Anesthesia Partners has defined the organization’s Fast Track Goals. They are to “shorten the patient’s hospital stay without sacrificing the patient’s safety, and to lessen the possibilities of complications.”