Advancing Quality NHS Advancing Quality Alliance

Hip or Knee Replacement Surgery

Joint replacement is a surgical procedure to replace joints affected by osteoarthritis.  Advancing Quality measures the replacement of Hips and Knees. The aim of replacing these joints is to increase function and mobility for patients and relieve pain.

Hip replacement is usually considered only after other therapies, such as physical therapy and pain medications, have failed. Knee replacement is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. Knee replacement surgery can be performed as a partial or a total knee replacement.

The most common reason a patient may need joint replacement surgery is osteoarthritis.

define:

Osteoarthritis is a condition that causes the joints to become painful and stiff. It is the most common type of arthritis in the UK.

NHS Choices

Through research, clinical input and clinical guidelines Advancing Quality has developed six measures that, when applied at the appropriate time, can greatly increase the outcomes for patients. Advancing Quality uses these measures to monitor the quality of care given to patients across the North West with the aim of improving standards and reducing variation in care.


Measures

1. Appropriate antibiotics up to one hour before surgery

It is important that you receive the right antibiotic for you and for the type of surgery you are having to stop you getting an infection.

2. Appropriate antibiotics selected to prevent infection

It is important that you receive the antibiotic up to an hour before surgery as it can reduce the risk of infection by 50%.

3. Appropriate antibiotics stopped within 24 hours after your operation

It is best to take antibiotics for a short a time as possible. There is no benefit for you in carrying on with antibiotics 24 hours after surgery.

4. Blood thinning medication ordered

VTE Prophylaxis thins the blood and reduces the risk of blood clots developing after surgery.

define:

A venous thrombus is a blood clot (thrombus) that forms within a vein. Thrombosis is a term for a blood clot occurring inside a blood vessel. A common type of venous thrombosis is a deep vein thrombosis (DVT), which is a blood clot in the deep veins of the leg. If the thrombus breaks off (embolizes) and flows towards the lungs, it can become a life-threatening pulmonary embolism (PE), a blood clot in the lungs. VTE therapy is the medication that thins the blood and reduces the risk of blood clots.

5. Blood thinning medication given within 12 hours of surgery

VTE Prophylaxis thins the blood and reduces the risk of blood clots developing after surgery. It is recommended that it should be effective if given within the first 12 hours after surgery.

define:

A venous thrombus is a blood clot (thrombus) that forms within a vein. Thrombosis is a term for a blood clot occurring inside a blood vessel. A common type of venous thrombosis is a deep vein thrombosis (DVT), which is a blood clot in the deep veins of the leg. If the thrombus breaks off (embolizes) and flows towards the lungs, it can become a life-threatening pulmonary embolism (PE), a blood clot in the lungs. VTE therapy is the medication that thins the blood and reduces the risk of blood clots.

6. VTE medication given for the right amount of time after surgery (Introduced Y6)

Your VTE should be prescribed for the right amount of time for your type of operation. For knee replacements this is 10 - 14 days and for hip replacements this is 28 - 35 days.

define:

A venous thrombus is a blood clot (thrombus) that forms within a vein. Thrombosis is a term for a blood clot occurring inside a blood vessel. A common type of venous thrombosis is a deep vein thrombosis (DVT), which is a blood clot in the deep veins of the leg. If the thrombus breaks off (embolizes) and flows towards the lungs, it can become a life-threatening pulmonary embolism (PE), a blood clot in the lungs. VTE therapy is the medication that thins the blood and reduces the risk of blood clots.
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