Optimising perioperative care for hip and knee arthroplasty in South Africa : a Delphi consensus study

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dc.contributor.authorPlenge, U.en_ZA
dc.contributor.authorNortje, M. B.en_ZA
dc.contributor.authorMarais, L. C.en_ZA
dc.contributor.authorJordaan, J. D.en_ZA
dc.contributor.authorParker, R.en_ZA
dc.contributor.authorVan der Westhuizen, N.en_ZA
dc.contributor.authorVan der Merwe, J. F.en_ZA
dc.contributor.authorMarais, J.en_ZA
dc.contributor.authorSeptember, W. V.en_ZA
dc.contributor.authorDavies, G. L.en_ZA
dc.contributor.authorPretorius, T.en_ZA
dc.contributor.authorSolomon, C.en_ZA
dc.contributor.authorRyan, P.en_ZA
dc.contributor.authorTorborg, A. M.en_ZA
dc.contributor.authorFarina, Z.en_ZA
dc.contributor.authorSmit, R.en_ZA
dc.contributor.authorCairns, C.en_ZA
dc.contributor.authorShanahan, H.en_ZA
dc.contributor.authorSombili, S.en_ZA
dc.contributor.authorMazibuko, A.en_ZA
dc.contributor.authorHobbs, H. R.en_ZA
dc.contributor.authorPorrill, O. S.en_ZA
dc.contributor.authorTimothy, N. E.en_ZA
dc.contributor.authorSiebritz, R. E.en_ZA
dc.contributor.authorVan der Westhuizen, C.en_ZA
dc.contributor.authorTroskie, A. J.en_ZA
dc.contributor.authorBlake, C. A.en_ZA
dc.contributor.authorGray, L. A.en_ZA
dc.contributor.authorMunting, T. W.en_ZA
dc.contributor.authorSteinhaus, H. K. S.en_ZA
dc.contributor.authorRowe, P.en_ZA
dc.contributor.authorVan der Walt, J. G.en_ZA
dc.contributor.authorIsaacs Noordien, R.en_ZA
dc.contributor.authorTheron, A.en_ZA
dc.contributor.authorBiccard, B. M.en_ZA
dc.date.accessioned2018-05-14T05:45:14Z
dc.date.available2018-05-14T05:45:14Z
dc.date.issued2018-05-09
dc.date.updated2018-05-13T04:34:17Z
dc.descriptionCITATION: Plenge, U., et al. 2018. Optimising perioperative care for hip and knee arthroplasty in South Africa : a Delphi consensus study. BMC Musculoskeletal Disorders, 19:140, doi:10.1186/s12891-018-2062-2.
dc.descriptionThe original publication is available at https://bmcmusculoskeletdisord.biomedcentral.com
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstractBackground: A structured approach to perioperative patient management based on an enhanced recovery pathway protocol facilitates early recovery and reduces morbidity in high income countries. However, in low- and middle-income countries (LMICs), the feasibility of implementing enhanced recovery pathways and its influence on patient outcomes is scarcely investigated. To inform similar practice in LMICs for total hip and knee arthroplasty, it is necessary to identify potential factors for inclusion in such a programme, appropriate for LMICs. Methods: Applying a Delphi method, 33 stakeholders (13 arthroplasty surgeons, 12 anaesthetists and 8 physiotherapists) from 10 state hospitals representing 4 South African provinces identified and prioritised i) risk factors associated with poor outcomes, ii) perioperative interventions to improve outcomes and iii) patient and clinical outcomes necessary to benchmark practice for patients scheduled for primary elective unilateral total hip and knee arthroplasty. Results: Thirty of the thirty-three stakeholders completed the 3 months Delphi study. The first round yielded i) 36 suggestions to preoperative risk factors, ii) 14 (preoperative), 18 (intraoperative) and 23 (postoperative) suggestions to best practices for perioperative interventions to improve outcomes and iii) 25 suggestions to important postsurgical outcomes. These items were prioritised by the group in the consecutive rounds and consensus was reached for the top ten priorities for each category. Conclusion: The consensus derived risk factors, perioperative interventions and important outcomes will inform the development of a structured, perioperative multidisciplinary enhanced patient care protocol for total hip and knee arthroplasty. It is anticipated that this study will provide the construct necessary for developing pragmatic enhanced care pathways aimed at improving patient outcomes after arthroplasty in LMICs.
dc.description.urihttps://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-018-2062-2
dc.description.versionPublisher's version
dc.format.extent6 pages
dc.identifier.citationPlenge, U., et al. 2018. Optimising perioperative care for hip and knee arthroplasty in South Africa : a Delphi consensus study. BMC Musculoskeletal Disorders, 19:140, doi:10.1186/s12891-018-2062-2
dc.identifier.issn1471-2474 (online)
dc.identifier.otherdoi:10.1186/s12891-018-2062-2
dc.identifier.urihttp://hdl.handle.net/10019.1/103995
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthor retains copyright
dc.subjectTotal knee replacementen_ZA
dc.subjectTotal hip replacementen_ZA
dc.subjectDelphi methoden_ZA
dc.subjectMedical economics -- Developing countriesen_ZA
dc.titleOptimising perioperative care for hip and knee arthroplasty in South Africa : a Delphi consensus studyen_ZA
dc.typeArticleen_ZA
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