OBJECTIVES

The global demand for Total Knee Arthroplasty (TKA) is increasing.With the rising challenge of affordability of care; maintaining a high quality of care alongside efficiency gains and cost control will become increasingly important. Length of Stay (LOS) is an important driver of hospital costs in health care systems and post discharge referrals to a rehabilitation centre also increases the cost of care versus home discharge.

METHODS

This article reports a single centre, single surgeon retrospective chart review that compares LOS and discharge destination between patients who received the ATTUNE® Knee System versus the SIGMA® Knee System in 200 consecutive patients treated with primary TKA in a Dutch hospital between 2015-2017. Pre-, intra- and post-operative management of patients was the same for both groups.

RESULTS

The study found patients treated with the ATTUNE Knee reported reductions in adjusted mean LOS (p<0.01). The adjusted means in the ATTUNE Knee and SIGMA Knee groups were 2.76 days (95% CI, 2.45 -3.10) and 3.43 days (95% CI, 3.08 - 3.81) respectively. Median LOS in the ATTUNE group was also reduced compared to the SIGMA Knee group (p<0.001). The adjusted-proportion of patients discharged to a rehabilitation centre was statistically significantly lower in the ATTUNE Knee group (4.4% [95% CI, 1.7% - 10.7%] vs 11.4% [95% CI, 6.0% - 20.6%], p<0.05). No statistical differences in patient demographics (age, ASA, gender, BMI) were found between the two treatment groups.

CONCLUSIONS

Results of this study are consistent with earlier studies and highlight the ATTUNE Knee may facilitate shorter LOS in TKA and increase the likelihood of home discharge. These improvements were achieved in a hospital environment with an established enhanced recovery program and a low baseline LOS.