In 2009, the Lundbeck Foundation donated 35 million kroner for the establishment of a Fast-track hip and knee replacement (THA/TKA) collaborative group.
The main focus of the fast-track collaboration was to optimize patient’s pathway and achive the “pain and risk free” hip or knee replacement. From 2010 the need for hospitalisation has descreased from about 3 days to median 1 day and reduction of usual medical complications without increase of readmissions.
Research from the fast-track collaboration has resulted in several dissertations and more than 200 peer reviewed publications, many in leading journals like Lancet, JAMA and Nature Communications.
In 2021, The NOVO Foundation donated 15 million kroner for continuation of the fast-track collaboration.
The following hospitals participates in the collaboration:
– Aalborg University Hospital, Farsø
– Hospital Unit West, Gødstrup
– Lillebaelt Hospital – Vejle
– Odense University Hospital, Svendborg
– Copenhagen University Hospital, Bispebjerg
– Copenhagen University Hospital, Herlev-Gentofte
– Copenhagen Univsersity Hospital, Hvidovre
– Næstved Hospital
The 8 centres perform about 8,500/year of primary THA/TKA/UKA (about 45 % of DK’s production).
The main aim of the fast-track collaboration is to reduce postoperative complications and enhance recovery after total hip and knee replacement surgery.
The fast-track collaboration focus on the current challenges:
- Further enhance early recovery and reduce the risk of postoperative complications (“to achieve the pain and risk free operation”) with a 90-days readmission risk from presently about 7 % to tentatively 3 % and with a specific focus on “high-risk” patients, for example the elderly (> 85 year) where the readmission rate is about 15 %.
- To improve the health care economic consequences by increasing the ratio of outpatient (ambulatory) THA/TKA in “low-risk” patients thereby saving resources for the future optimisation of the perioperative course for “high-risk” patients. The focus will be to increase the proportion of outpatient surgery from now about 5 % to about 25 %, without increasing the rate of complications and readmissions.
The fast-track collaboration have established a national REDCap database. The database is managed from Open Patient data Explorative Network (OPEN) in Odense University Hospital. Data are continuously collected from all patients undergoing surgery at the participating hospitals and annually crossed with LPR3 to secure 100 % 90-day-follow-up.