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"I'M PLANNING ON HAVING MY KNEES REPLACED. FOR HOW LONG WILL I BE REQUIRED TO STAY AT THE HOSPITAL?" - A LOOK AT THE IMPORTANT PREDICTORS OF LENGTH OF STAY AFTER A PRIMARY TOTAL KNEE REPLACEMENT IN A LARGE COHORT.


Presenting Author - VISHESH KHANNA
Introduction: With increasing total knee replacements (TKRs), a consequent hike in postoperative patients appears inevitable. While the last 4 decades have witnessed a fall in the length of hospital-stay (LOS) from 21 to 3 days, preoperative determinants of LOS after TKR remain unclear. One of the commonest patient-FAQs, the LOS also possesses an inverse relationship with patient satisfaction. The aim of this research was to obviate the uncertainties surrounding factors responsible for prolonging LOS by ascertaining the crucial ones through a retrospective analysis of a large cohort of patients. Methods: At our tertiary-care, teaching center (performing the second-highest joint replacement surgeries in the Asia-Pacific region), charts of 2,450 TKRs performed between January 2016 and March 2017 were reviewed. LOS was defined as the number of days from surgery till discharge. Records were analysed for preoperative variables [age, gender, address, height, weight, body-mass-index, cash vs insurance, etiology, duration of symptoms, comorbidities, deformities, range-of-motion, American Society of Anaesthesiologists grade, preoperative hemoglobin, preoperative Knee Society Function Score (KFS) and Oxford Knee Score (OKS)] that might be significantly associated with prolonging LOS. Patients aged above 40 who underwent a unilateral (U/L), staggered bilateral or a simultaneous, single-stage B/L TKR were included. Complex-primary and revision TKRs were excluded. Data analysis was done using Spearman’s rank correlation (continuous variables), Mann-Whitney and Kruskal-Wallis (discrete variables) tests. Multivariate regression analysis was performed to identify significant factors affecting the LOS (2-tailed, p significant).