Comparing outcomes between enhanced recovery after surgery and traditional protocols in total knee arthroplasty : a retrospective cohort study

BACKGROUND : Knee replacement surgery was traditionally associated with prolonged recovery and rehabilitation programmes in hospital. Enhanced recovery after surgery (ERAS) protocols have been shown to be cost effective while not compromising patient safety or functional outcome. Despite this proven efficacy, ERAS has not been widely adopted in South African orthopaedic practices. The aim of this study is to determine if it is possible to practise these guidelines in South Africa so as to decrease the length of stay (LOS) without an increase in complication rate or compromise in functional outcome. METHODS : Included in the study were 119 patients undergoing elective total knee arthroplasty between 2013 and 2017. They were divided into two cohorts. The first group was treated with a traditional protocol and included 59 patients. The second group was treated with ERAS and included 60 patients, following implementation of the ERAS protocol in 2015. The functional outcome was assessed using the Oxford Knee Score (OKS). The 30-day readmission rate was used to assess safety of early discharge. LOS and patient demographics were also collected to compare the cohorts. RESULTS : There was no clinically significant difference between the cohorts with regards to OKS or readmission rate. Two sample t-tests were used to compare these parameters. The mean OKS for the traditional group was 59.1 (SD 2.4), and for the ERAS group, 58.7 (SD 5.0) (p = 0.73). The readmission rate was 8.5% in the traditional group and 10% in the ERAS group (p = 1.00). The LOS was significantly decreased in the ERAS group, with a mean of 2.3 days (SD 1.8) compared to 5.0 (SD 2.2) in the traditional group (p < 0.001). CONCLUSION : ERAS protocols used in the South African context in elective total knee arthroplasty significantly decrease the LOS without compromising patient safety or functional outcome.http://journal.saoa.org.zadm2022Orthopaedic Surger

Curing kinetics of diallyl phthalate in the presence of dicumyl peroxide as catalyst. A comparison of different data analysis techniques

The curing kinetics of diallyl phthalate in the presence of dicumyl peroxide as catalyst were studied by means of the single dynamic temperature scan DSC method. The curing process is accomplished by the liberation of heat and appears as an exotherm on the DSC thermogram. Different data analysis methods were employed to analyse the reaction exotherm and to obtain the kinetic parameters. The rate constants obtained by means of the cut-and-weigh method, as well as those calculated from the residual heats of reaction after different oven curing times, were in excellent agreement with the values obtained by using the Borchardt and Daniels DSC kinetics data analysis software (supplied by Du Pont). It was evident from the results of this study that all the data analysis methods were suitable for determining the kinetic parameters of thermoset curing reactions which follow first-order kinetics. However, this study has shown conclusively that the analysis speed and simplicity of the Borchardt and Daniels DSC kinetics program make this the preferred method for obtaining quantitative reaction kinetics information for the curing of thermoset resins. © 1993.Articl