Recovery from knee replacement surgery can be delayed by pain and swelling caused by the operation. Encouraging range of movement and mobilisation as soon as possible after surgery is part of the ‘Enhanced Recovery after Surgery’ pathway at Cheltenham General Hospital.
Thanks to a grant from the Gloucestershire Arthritis Trust (GAT), and in partnership with PhysioLab Technologies who have designed an innovative cryotherapy system, Orthopaedic Surgeon Peter Kempshall will undertake a pilot study of 200 knee replacement patients to undergo cryotherapy postoperatively, starting in July.
His team will monitor cryotherapy effectiveness by measuring length of stay and pain scales/analgesia requirements. They will initially perform 100 cases and then evaluate results with a view to refining their processes in the second cohort of the next 100 patients.
Length of stay (LoS) for knee replacements is four days at present. As part of their ‘Enhanced Recovery’ package, Peter believes he can improve this significantly and this would be one of our outcome measures. Other key performance indicators will be: VAS for pain at multiple time points; analgesic use in hospital; thigh and calf circumference; patient satisfaction and the time it takes to return to or above baseline on knee scores.
If LoS reduces by 0.5 days, that could free up 250 bed-days in a full year allowing us to provide more elective surgery. It will also free up physiotherapy time to treat more patients whilst putting patients at the centre of their recovery programme too.