Special orthopaedic geriatrics (SOG) - a new multiprofessional care model for elderly patients in elective orthopaedic surgery: a study protocol for a prospective randomized controlled trial of a multimodal intervention in frail patients with hip and knee replacement

URN to cite this document:

urn:nbn:de:bvb:355-epub-534417 Copy

DOI to cite this document:

10.5283/epub.53441 Copy

Kappenschneider, Tobias ; Maderbacher, Günther ; Weber, Markus ; Greimel, Felix ; Holzapfel, Dominik Emanuel ; Parik, Lukas ; Schwarz, Timo ; Leiss, Franziska ; Knebl, Michael ; Reinhard, Jan ; Schraag, Amadeus Dominik ; Thieme, Max ; Turn, Agathe ; Götz, Julia ; Zborilova, Magdalena ; Pulido, Loreto C. ; Azar, Fady ; Spörrer, Jan-Frederik ; Oblinger, Britta ; Pfalzgraf, Frederik ; Sundmacher, Leonie ; Iashchenko, Iryna ; Franke, Sebastian ; Trabold, Benedikt ; Michalk, Katrin ; Grifka, Joachim ; Meyer, Matthias

License: Creative Commons Attribution 4.0 PDF - Published Version (2MB)

Date of publication of this fulltext: 20 Dec 2022 06:21

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Details

Item type:	Article
Open Access Type:	DEAL (Springer Gold)
Höhe Gebühr (aus OpenAPC):	1960.79
Institution der Zahlung:	Regensburg U
Journal or Publication Title:	BMC Musculoskeletal Disorders
Publisher:	BMC
Place of Publication:	LONDON
Volume:	23
Number of Issue or Book Chapter:	1
Date:	9 December 2022
Institutions:	Medicine > Lehrstuhl für Orthopädie
Identification Number:	Value Type 10.1186/s12891-022-05955-w DOI
Keywords:	OLDER PATIENTS; ORTHOGERIATRIC COMANAGEMENT; SURGICAL COMPLICATIONS; WESTERN ONTARIO; VALIDATION; MORTALITY; RISK; FRACTURE; OUTCOMES; PEOPLE; Orthogeriatric; Orthogeriatric co-management (OGC); Geriatric; Total hip arthroplasty (THA); Total knee arthroplasty (TKA); Elderly patients; Frailty; Multiprofessional care; Perioperative Care of Older Persons (POPS); Comprehensive geriatric assessment (CGA)
Dewey Decimal Classification:	600 Technology > 610 Medical sciences Medicine
Status:	Published
Refereed:	Yes, this version has been refereed
Created at the University of Regensburg:	Partially
Item ID:	53441

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Abstract

Background: Due to demographic change, the number of older people in Germany and worldwide will continue to rise in the coming decades. As a result, the number of elderly and frail patients undergoing total hip and knee arthroplasty is projected to increase significantly in the coming years. In order to reduce risk of complications and improve postoperative outcome, it can be beneficial to ...

Abstract

Background: Due to demographic change, the number of older people in Germany and worldwide will continue to rise in the coming decades. As a result, the number of elderly and frail patients undergoing total hip and knee arthroplasty is projected to increase significantly in the coming years. In order to reduce risk of complications and improve postoperative outcome, it can be beneficial to optimally prepare geriatric patients before orthopaedic surgery and to provide perioperative care by a multiprofessional orthogeriatric team. The aim of this comprehensive interventional study is to assess wether multimorbid patients can benefit from the new care model of special orthopaedic geriatrics (SOG) in elective total hip and knee arthroplasty. Methods: The SOG study is a registered, monocentric, prospective, randomized controlled trial (RCT) funded by the German Federal Joint Committee (GBA). This parallel group RCT with a total of 310 patients is intended to investigate the specially developed multimodal care model for orthogeriatric patients with total hip and knee arthroplasty (intervention group), which already begins preoperatively, in comparison to the usual orthopaedic care without orthogeriatric co-management (control group). Patients >= 70 years of age with multimorbidity or generally patients >= 80 years of age due to increased vulnerability with indication for elective primary total hip and knee arthroplasty can be included in the study. Exclusion criteria are age < 70 years, previous bony surgery or tumor in the area of the joint to be treated, infection and increased need for care (care level >= 4). The primary outcome is mobility measured by the Short Physical Performance Battery (SPPB). Secondary outcomes are morbidity, mortality, postoperative complications, delirium, cognition, mood, frailty, (instrumental) activities of daily living, malnutrition, pain, polypharmacy, and patient reported outcome measures. Tertiary outcomes are length of hospital stay, readmission rate, reoperation rate, transfusion rate, and time to rehabilitation. The study data will be collected preoperative, postoperative day 1 to 7, 4 to 6 weeks and 3 months after surgery. Discussion: Studies have shown that orthogeriatric co-management models in the treatment of hip fractures lead to significantly reduced morbidity and mortality rates. However, there are hardly any data available on the elective orthopaedic care of geriatric patients, especially in total hip and knee arthroplasty. In contrast to the care of trauma patients, optimal preoperative intervention is usually possible.

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Metadata last modified: 15 Mar 2023 14:55

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