Retrospective Chart Review of Patients Following Unilateral Total Knee Replacement to Assess Achievement of Functional Milestones Based on Type of Anesthetic Used Intra-Operatively

<p>PURPOSE: Given the large number of Total Knee Replacements (TKR) performed annually in the US and the prediction that those numbers will increase, providing optimal analgesia during TKR is an important strategy for reducing cost and improving patient outcomes. Currently, no standard analgesia protocol for TKR exists and facilities in the US and world-wide use varied methods of analgesia. The purpose of the present study is to determine which analgesic technique; femoral nerve block (FNB), saphenous nerve block (SNB) or periarticular injection (PAI), within the context of a multi-modal pain management regimen, results in optimal TKR patient outcomes and achievement of functional milestones, as well as decreased length of stay (LOS).</p> <p>METHODS: A retrospective, non-randomized design was employed using a convenience sample of 1,644 patients undergoing primary, unilateral TKR at HSS. 652 patients were included in the FNB group, 873 patients in the SNB group, and 119 patients in the PAI group. Physical therapists assessing and treating patients post-operatively, documented LOS and achievement of functional milestones, including the ability to transfer, ambulate and perform stairs. The data was analyzed to determine if the various methods of analgesia are associated with improved patient outcomes.</p> <p>RESULTS: A significant statistical difference in LOS (p</p> <p>CONCLUSIONS: This study suggests that alternate methods of perioperative anesthesia used in TKR, including SNB and PAI, are associated with improved outcomes over FNB. This review supports further research of both SNB and PAI techniques due to their potential in improving patient functional outcomes, reducing LOS and decreasing costs.</p>

Name thesis:degree_name

Doctor of Physical Therapy

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Physical Therapy

Grantor

The Graduate School and University Center of The City University of New York

Year dc:date.available

2015

Authors dc:creator

• Benish, William S
• Chong, Lolline
• Kram, Elana
• Krieger, Danielle

Advisor dc:contributor.advisor

• Elaine Rosen

• Physical Therapy

Repository record dc:identifier

https://academicworks.cuny.edu/gc_etds/697

OAI identifier oai:identifier

oai:academicworks.cuny.edu:gc_etds-1728