Comparison of two accelerated clinical pathways – after

Objective: To evaluate whether a further optimization of an existing accelerated clinical pathway protocol after total knee replacement is feasible and improves postoperative outcome. Design: Prospective, parallel group design. Setting: Orthopaedic University Medical Centre. Patients: A total of 143 patients, scheduled for unilateral primary total knee replacement under perioperative regional analgesia. Intervention: Sixty-seven patients received an optimized accelerated clinical pathway including patient-controlled regional analgesia pumps, ultra-early/doubled physiotherapy and motor-driven continuous passive motion machine units. Seventy-six patients received a standard accelerated clinical pathway. Main measures: Feasibility was defined as the proportion of patients successfully completing the assigned pathway. Early postoperative pain on a visual analogue scale, consumption of regional anaesthetics, knee range of motion, time out of bed, non-stop walking distance/stair climbing, circumference measurement an