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HIGH TIBIAL OSTEOTOMIES (HTO) CAN BE DONE WITHOUT HOSPITALIZATION 

HIGH TIBIAL OSTEOTOMIES (HTO) CAN BE DONE WITHOUT HOSPITALIZATION . CONVERTING ORTHOPAEDIC SURGERY FROM AN IN-PATIENT TO AN OUT-PATIENT PROCEDURE. OBJECTIVE

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HIGH TIBIAL OSTEOTOMIES (HTO) CAN BE DONE WITHOUT HOSPITALIZATION 

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  1. HIGH TIBIAL OSTEOTOMIES (HTO) CAN BE DONE WITHOUT HOSPITALIZATION  CONVERTING ORTHOPAEDIC SURGERY FROM AN IN-PATIENT TO AN OUT-PATIENT PROCEDURE OBJECTIVE In-patient treatment of younger patients suffering from arthrosis of the medial part of the knee (HTO) needed hospitalization for 2-3 days particularly because of pain. Anaesthesiologists and surgeons focused on pain management. A regional infiltration analgesic catheter (RIA) was located in the osteotomy which delivered Naropin for 48 hours after surgery combined with local infiltration analgesic (LIA). A pain package for 10 days after surgery was handed to the patients. The patients had no pain after the operation, which would have required hospitalization. METHOD 11 patients have been operated in Day Surgery Unit (DKE), Regional Hospital Herning, Denmark (5 women and 6 men between the age of 40-56 years). At discharge the patients received written and verbal information about the analgesic catheter and pain management. EVALUATION WAS CARRIED OUT BY A QUESTIONNAIRE AND PATIENT INTERVIEWS 2 DAYS AFTER SURGERY • WHY SUCH A SUCCESS? • Thorough information about the surgery, even before check-in • Unique pain treatment attacking from three fronts • Targeted directly into the osteotomy using an anesthetic catheter • Local anesthetics • Prepacked amount of painkillers for the patient to bring home • Highly skilled staff in the ward RESULTS 9 patients took the recommended p.n. medication because of pain and told the interviewer that they felt comfortable as out-patients in Day Surgery Unit. 2 patients did not need to take the recommended p.n. medicine after discharge. No complications or re-hospitalization were found.  CONCLUSION These patients will now be offered surgery as out-patients in Day Surgery Unit containing instruction prior to surgery. This includes information about pain management, rehabilitation, anticoagulation therapy, wound care etc.  Nurses Bodil Andersen-Møller, Lene Kjærsgaard, Merete Kjeldsgaard and Anita Døfler | Day Surgery Unit |Herning Regional Hospital | Denmark | bodil.andersen-moeller@vest.rm.dk | April 2011

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