The factors determining early mobilization in elderly patients undergoing total knee replacement
Abstract Background Postoperative early mobilization after total knee replacement (TKR) is essential for preventing complications and offers numerous benefits. The purpose of this study was to evaluate the factors determining early mobilization (EM) after primary TKR and the effects on risk of falls...
| Κύριοι συγγραφείς: | , , , |
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| Μορφή: | Άρθρο |
| Γλώσσα: | English |
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BMC
2025-02-01
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| Σειρά: | BMC Geriatrics |
| Θέματα: | |
| Διαθέσιμο Online: | https://doi.org/10.1186/s12877-025-05772-5 |
| _version_ | 1826585678631141376 |
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| author | Li-Ling Hung Yong-Chuan Chen Yu-Ting Wang Shun-Ping Wang |
| author_facet | Li-Ling Hung Yong-Chuan Chen Yu-Ting Wang Shun-Ping Wang |
| author_sort | Li-Ling Hung |
| collection | DOAJ |
| description | Abstract Background Postoperative early mobilization after total knee replacement (TKR) is essential for preventing complications and offers numerous benefits. The purpose of this study was to evaluate the factors determining early mobilization (EM) after primary TKR and the effects on risk of falls and length of stay (LOS). Methods This retrospective study recruited elder participants undergoing primary TKR. All patients were classified as EM(+), early mobilization (EM) within 24 h, or EM(-), delayed mobilization over 24 h. Demographic data, pain Visual Analog Scale (VAS), American Society of Anesthesiologists (ASA) score, perioperative blood pressure, postoperative pain control mode, medical catheters, dizziness or nausea/vomiting (PONV), falls during admission, and the LOS were collected. Result A total of 1759 elder participants undergoing primary TKR were enrolled. Mean age was 73.00 ± 8.11 years. Among them, there were 1260 EM(-) and 499 EM(+) cases, with no significant differences in sex, BMI, PONV, postoperative Patient Controlled Analgesia (PCA) mode, or the use of medical catheters, but age, higher ASA score, VAS, muscle strength, postoperative nausea, and substantial changes of blood pressure were significantly different between the two groups. A greater reduction in systolic blood pressure, when compared to the preoperative baseline blood pressure, was found in EM(-) patients than EM(+) patients on the operative day (13 vs. 4 mmHg, P < 0.001) and first day post-TKR (20 vs. 17 mmHg, P = 0.005). LOS in EM(-) patients was significant longer than that in EM(+) patients, but risk of falls was not significantly different. Conclusions Multiple factors influence patients’ willingness to mobilize or ambulate earlier. However, more blood pressure reduction impeding early mobilization after TKR should be addressed. Maintaining post-TKR blood pressure without significant decreases is recommended for the successful mobilization after surgery. Early mobilization within 24 h after TKR may be beneficial in reducing the LOS and did not increase risk of falls. |
| first_indexed | 2025-03-14T15:57:28Z |
| format | Article |
| id | doaj.art-ddcc697492854aba8d51567929445225 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2025-03-14T15:57:28Z |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-ddcc697492854aba8d515679294452252025-02-23T12:41:58ZengBMCBMC Geriatrics1471-23182025-02-0125111110.1186/s12877-025-05772-5The factors determining early mobilization in elderly patients undergoing total knee replacementLi-Ling Hung0Yong-Chuan Chen1Yu-Ting Wang2Shun-Ping Wang3Department of Nursing, Taichung Veterans General HospitalDepartment of Nursing, Taichung Veterans General HospitalDepartment of Nursing, China Medical UniversityDepartment of Orthopaedics, Taichung Veterans General HospitalAbstract Background Postoperative early mobilization after total knee replacement (TKR) is essential for preventing complications and offers numerous benefits. The purpose of this study was to evaluate the factors determining early mobilization (EM) after primary TKR and the effects on risk of falls and length of stay (LOS). Methods This retrospective study recruited elder participants undergoing primary TKR. All patients were classified as EM(+), early mobilization (EM) within 24 h, or EM(-), delayed mobilization over 24 h. Demographic data, pain Visual Analog Scale (VAS), American Society of Anesthesiologists (ASA) score, perioperative blood pressure, postoperative pain control mode, medical catheters, dizziness or nausea/vomiting (PONV), falls during admission, and the LOS were collected. Result A total of 1759 elder participants undergoing primary TKR were enrolled. Mean age was 73.00 ± 8.11 years. Among them, there were 1260 EM(-) and 499 EM(+) cases, with no significant differences in sex, BMI, PONV, postoperative Patient Controlled Analgesia (PCA) mode, or the use of medical catheters, but age, higher ASA score, VAS, muscle strength, postoperative nausea, and substantial changes of blood pressure were significantly different between the two groups. A greater reduction in systolic blood pressure, when compared to the preoperative baseline blood pressure, was found in EM(-) patients than EM(+) patients on the operative day (13 vs. 4 mmHg, P < 0.001) and first day post-TKR (20 vs. 17 mmHg, P = 0.005). LOS in EM(-) patients was significant longer than that in EM(+) patients, but risk of falls was not significantly different. Conclusions Multiple factors influence patients’ willingness to mobilize or ambulate earlier. However, more blood pressure reduction impeding early mobilization after TKR should be addressed. Maintaining post-TKR blood pressure without significant decreases is recommended for the successful mobilization after surgery. Early mobilization within 24 h after TKR may be beneficial in reducing the LOS and did not increase risk of falls.https://doi.org/10.1186/s12877-025-05772-5Early mobilizationFallERASTotal knee replacementLength of Stay |
| spellingShingle | Li-Ling Hung Yong-Chuan Chen Yu-Ting Wang Shun-Ping Wang The factors determining early mobilization in elderly patients undergoing total knee replacement BMC Geriatrics Early mobilization Fall ERAS Total knee replacement Length of Stay |
| title | The factors determining early mobilization in elderly patients undergoing total knee replacement |
| title_full | The factors determining early mobilization in elderly patients undergoing total knee replacement |
| title_fullStr | The factors determining early mobilization in elderly patients undergoing total knee replacement |
| title_full_unstemmed | The factors determining early mobilization in elderly patients undergoing total knee replacement |
| title_short | The factors determining early mobilization in elderly patients undergoing total knee replacement |
| title_sort | factors determining early mobilization in elderly patients undergoing total knee replacement |
| topic | Early mobilization Fall ERAS Total knee replacement Length of Stay |
| url | https://doi.org/10.1186/s12877-025-05772-5 |
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