gms | German Medical Science

Objectives: The objective of the retrospective study was to evaluate the feasibility and complications of TKA as a one day procedure with the "LaZIRUSh" method.

Methods: We performed in XXX 80 TKA as a one day procedure. The used method was a pathway for TKA called "LaZIRUSh"

The method or program contains a Teaching Class, General Anesthesia, EMS (Eeklo Modifies Subvastus) approach , PIPB (patella in Place Balancer), No ligament releases, Single Radius TKP, Perop Lokal Pain (PLP) managment, Early mobilization

Teaching Class: Once a month for all patients (no selection)

General Anesthesia: Maximal Muscle relaxation and low BP (syst around 90 mmHG)

EMS: A Far medial Subvastus Approach with preservtion of priosium, Hoffa, Sub quad Patellar pouch

PIPB: A tibia first method with a ligament balancer in flexion with patella in place. The natural hight of the flexion gap is measured. The posterior femoral cut is done at the desired hight with preservation of a the natural posterior offset and parallel to the tibia. Releases are never done and necessary. The extension gap is adapted to the flexion gap

Single Radius TKP: Because of the isometrie of the collateral ligaments a single radius is mandatory to get a equal flexion-extension gap

PLP: Lokal intraarticulair infiltration (Ropivacaïne, Adrenaline and MgSO4). No opstop epiridural postop painpump or nerve blocks are necessary.

Early mobilization: Same day mobilization and discharge from the hospital to theire proper home

Results: First patient was done in 2007. 80 patients chose to go home the same day. No readmission was necessary. No mayor complication observed.

Conclusion: TKA as a one day procedure with the LaZIRUSh method is safe and can be proposed to prepared patients.