DOS 2020
192 · DOS Abstracts Fast-track Total Ankle Replacement – A Single Center Experience Christopher Jantzen, Lars B. Ebskov, Kim H. Andersen, Mostafa Benyahia, Peter Bro-Rasmusssen, Jens K. Johansen Department of Orthopedic Surgery, Foot and Ankle Section , Hvidovre University Hospital, Copenhagen, Denmark Background: Total ankle replacement (TAR) is a rapidly growing treatment for end-stage ankle arthritis. TAR is generally performed as an inpatient procedure with an average length of stay between 2.5-3.2 days. Previous studies have shown that out-patient TAR is safe and cost-effective but others have found increased complication rates associated with out- clinic surgery but the litera- ture is sparse on this topic. Purpose / Aim of Study: To evaluate the admission length together with complication, re-admission and non-scheduled contact to the out-patient clinic rates in patients operated with TAR at Hvidove University Hospital. The study also aims at identifying risk factors associated with admission length >1 day. Materials and Methods: Since 11th of December 2015 all patients treated at Hvidovre University Hospital with TAR have been subjected to the fast track setting where discharge is planned the first post-operative weekday after cast application. For this study data was collected on all patients treated during the period 11th of December 2015 to 1th of October 2019 with a minimum of three months follow-up. Data was collected regarding age, sex, ASA-score, BMI, co-morbidity, complications-, re-admission rates and non-scheduled con- tact to the out-patient clinic. Findings / Results: 151 patients were included. No difference was found be- tween patients discharged after one day when compared with those admitted >1 day. 54.3% was discharged one day after surgery while 32.4 % was dis- charged after 2 days and 13.3 % after >2 days. The overall readmission rate was 1.95 % while 5.96 % had a complication and 16.65 % had a non- sched- uled contact to the out-patient clinic. None of the included variables was found associated with admission length >1 day in both uni- and multivariate logistic regression analysis. Conclusions: Fast track TAR seems safe even though only 50 % of the patients could cohere to this. The main reasons for prolonged admission was soft-tissue swelling not allowing cast application or surgery at the end of the week delay- ing cast application. Also, special attention has to be made regarding analgesic treatment and cast application, in order to reduce the number of non-scheduled contacts to the out-patient clinic. 171.
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