Evid Based Nurs 2:123 doi:10.1136/ebn.2.4.123
  • Treatment

A clinical pathway reduced length of stay, time to ambulation, and complications after hip and knee arthroplasty

 Question Does the use of a clinical pathway improve patient outcomes after hip or knee arthroplasty?


Randomised, unblinded, controlled trial with ≥3 months follow up.


A tertiary referral hospital in Melbourne, Victoria, Australia.


175 patients who had hip or knee arthroplasty between January 1996 and December 1997. 12 patients (6.9%) were excluded after randomisation because they were having revision arthroplasty, simultaneous bilateral joint arthroplasty, arthroplasty for acute trauma, or complex tumour surgery. The remaining 163 patients (mean age 66 y, 66% women) completed ≥3 months of follow up.


92 patients were allocated to the clinical pathway group and 71 were allocated to the control group. Patients in the clinical pathway group received “proactive” treatment whereby specific daily goals were set for the patient and the healthcare team. A written protocol identified milestones to be achieved, tests …

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