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Knee: I. D. M. Smith, R. Elton, J. A. Ballantyne, and I. J. Brenkel Pre-operative predictors of the length of hospital stay in total knee replacement J Bone Joint Surg Br 2008; 90-B: 1435-1440 [Abstract] [Full text] [PDF]

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Author's reply:

Ivan J Brenkel   (13 February 2009)

Pre-operative predictors of the length of hospital stay in total knee replacement

Marcus O. Head, Richard T. Roach   (5 February 2009)

Author's reply: 13 February 2009
Ivan J Brenkel, consultant NHS Fife Send letter to journal: Re: Author's reply: ivan.brenkel{at}faht.scot.nhs.uk Ivan J Brenkel	Sir, I would like to thank Mr Head for his comments on our paper. I agree that physiotherapy on weekends may improve length of stay and we are looking at this. Were the age and ASA scores in each hospital the same? Post-operative pain relief following surgery, and nursing attitudes, are also important in decreasing length of stay. I.J. Brenkel, Consultant Orthopaedic Surgeon, Queen Margaret Hospital, Dunfermline, UK.
Pre-operative predictors of the length of hospital stay in total knee replacement 5 February 2009
Marcus O. Head, SpR Orthopaedics Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK, Richard T. Roach Send letter to journal: Re: Pre-operative predictors of the length of hospital stay in total knee replacement marcushead{at}doctors.net.uk Marcus O. Head, et al.	Sir, We read with interest the article by Smith et al concerning pre-operative predictors of length of stay following total knee arthroplasty. To follow on from information presented we have reviewed the results of a single surgeon series of 150 primary elective knee replacements performed in three hospitals concurrently. There appeared to be no variance in demographic data, however, a district general hospital had an extended stay of two days over a specialist elective orthopaedic hospital and a private hospital (mean 8 days, median and mode 7 compared with mean 6.5 and 5, and 5.5 and 5 respectively). We believe this difference is due to lack of weekend physiotherapy, a focused mindset by staff and the exposure of recuperating patients to others having the same procedure. We wonder if the authors would agree in principle to this finding. M.O. Head, SpR Orthopaedics, R.T. Roach, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK.