[Preoperative management in fast-track arthroplasty].

Abstract

Preoperative management of patients following fast-track arthroplasty protocols includes comprehensive patient information and risk stratification. Fast-track protocols have implemented interdisciplinary patient seminars to explain the disease, operation, pain management, early mobilisation and each step of the patient pathway, as well as the role of afriend or relative as a"coach" during the whole process of treatment and rehabilitation to support and encourage the patient. There is strong evidence that preoperative anxiety is reduced. Digital apps can provide further information, practical tips and instructional videos to improve functional outcomes and to reduce pain levels. Risk factors such as malnutrition, obesity, smoking, alcohol abuse, uncontrolled diabetes, and poor dental health are associated with ahigher morbidity, mortality, complication rate and alonger length of stay and have to be assessed preoperatively and optimized if possible.