Accelerated discharge following total knee replacement with local anaesthetic infusion

A. Chu, D. Cadoux-Hudson, D. Clarke, H. Fox, C. Bailey
2015 International Journal of Surgery  
Methods: Electronic records were retrospectively analysed for all patients undergoing joint aspiration for suspected septic arthritis between 2013 and 2014 (N ¼ 155). Patients with skeletal immaturity and prosthetic joints were excluded. Outcome measures included length of stay and final diagnoses. Results: Knee aspirations were most commonly performed (N ¼ 108). Of these 40% of patients were discharged before 48 hours (prior to culture/ crystal results being available). 2 patients had positive
more » ... tients had positive gram-stain results and were treated as septic arthritis. 55 patients had positive crystal results (N.B crystal analysis not performed in 18 patients). Conclusion: Referrals from ED for swollen knee joints are the most common. However, only a minority of these have eventual diagnoses of septic arthritis. We propose that patients without overt signs of sepsis deemed suitable for discharge may be initially managed without orthopaedic input, with subsequent follow up with Orthopaedic or Rheumatology services once full culture/crystal results are available.
doi:10.1016/j.ijsu.2015.07.395 fatcat:laogeugcdvatlj42kqjx23d74e