Early mobilization after total hip or knee arthroplasty: a substudy of the POWER.2 study

Ripollés‐Melchor, Javier; Aldecoa, César; Fernández-García, Raquel; Varela-Durán, Marina; Aracil-Escoda, Norma; Garcia-Rodriguez, Daniel; Cabezudo-de-la-Muela, Lucia; Hormaechea-Bolado, Lucía; Alcorta, B. Nacarino; Hoffmann, Ralph; Lorente, J.V.; Ramírez-Rodríguez, José Manuel; Abad‐Motos, Ane

doi:10.1016/j.bjane.2021.05.008

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Vendittoli et al in their ERAS short-stay protocol for THA managed to improve patient evolution by reducing the complication rate by 15% versus standard protocol. Women had longer stays than men and patients living alone stayed longer, which has also been shown in most studies [23][24][25][26]. There is no clear-cut explanation for this finding.…”

Section: Discussionmentioning

confidence: 75%

Anterior Approach to Hip Arthroplasty with Early Mobilization Key for Reduced Hospital Length of Stay

Bontea,

Bimbo-Szuhai,

Macovei

et al. 2023

Medicina

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Background and Objectives: This study aimed to explore the preoperative factors related to early mobilization and length of stay (LOS) after total hip arthroplasty and the benefits of the anterior approach over the traditional lateral approach. Materials and Methods: Every patient benefits from information regarding details of the surgery approach, possible intra, and postoperative complications, post-operator medical care, and steps in the early mobilization protocol. The patient underwent a pre-anesthetic evaluation, was checked for preoperatory vital function, and was reevaluated for mobilization at 6, 12, 24, 36, 48, and 96 h after total hip arthroplasty using the anterior versus lateral approach. Results: The result of the statistical calculations indicates the independent negative risk factors for reaching the mobilization target: age with a coefficient of −0.046, p = 0.0154 and lateral approach with a relative risk of 0.3802 (95% CI: 0.15–0.90), p = 0.0298. Statistical data concerning the length of stay (LOS) showed significant differences in the total days spent in the hospital. The patients who were operated on using the lateral approach presented a higher body mass index than those with the anterior approach, but this difference did not reach the threshold of statistical significance. Conclusions: In our study, patient mobilization is crucial to reduce LOS.

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Section: Discussionmentioning

confidence: 75%

Anterior Approach to Hip Arthroplasty with Early Mobilization Key for Reduced Hospital Length of Stay

Bontea,

Bimbo-Szuhai,

Macovei

et al. 2023

Medicina

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“…The expedited ambulation following surgery contributed to reduced complications while improving overall function in the immediate postoperative phase. In addition, early mobilization reduced the overall number of physiotherapy sessions required for functional autonomy [ 39 , 47 , 49 , 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol

Sivaloganathan

Blakeney

Vendittoli

2022

JCM

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Pressure to reduce healthcare costs, limited hospital availability along with improvements in surgical technique and perioperative care motivated many centers to focus on outpatient pathway implementation. However, in many short-stay protocols, the focus has shifted away from aiming to reduce complications and improved rehabilitation, to using length of stay as the main factor of success. To improve patient outcomes and maintain safety, the best way to implement a successful outpatient program would be to combine it with the principles of enhanced recovery after surgery (ERAS), and to improve patient recovery to a level where the patient is able to leave the hospital sooner. This article delivers a case for modernizing total hip arthroplasty perioperative pathways by implementing ERAS-outpatient protocols.

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“…Неудивительно, что количество этих операций, ежегодно выполняемых во всём мире, довольно давно исчисляется сотнями тысяч и продолжает расти [6,7,8]. Уже в нынешнем десятилетии эндопротезирование крупных суставов нижней конечности обещает стать наиболее часто выполняемым видом планового хирургического вмешательства, объективной предпосылкой чему является всё более широкая распространённость остеопороза, остеоартрита, ревматоидных заболеваний и переломов бедра [6,8,9].…”

Section: Discussionunclassified

“…Краеугольным камнем послеоперационной реабилитации пациентов, перенёсших тотальное эндопротезирование тазобедренного или коленного суставов, является ранняя активизация [7,24]. А все методы проводниковой анестезии ассоциируются с двигательной блокадой [24,44].…”

Section: Discussionunclassified

The difficulty of choosing the method of analgesia after total replacement of the lower limb large joints (case report, literature review)

Lebed

Kirpichenko

Vasilyev

et al. 2022

Acta biomedica scientifica

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A case of successful treatment of a patient with a periprosthetic fracture of the femur is described. The fracture occurred one day after total hip replacement as a result of a fall, possibly associated with postoperative conduction analgesia. Lower limb large joints total replacement may become the most frequently performed type of elective surgery already in the current decade. The increasing prevalence of osteoporosis, osteoarthritis, rheumatic diseases and hip fractures is an objective prerequisite for it. Despite of all efforts, the problem of postoperative pain control during these surgical interventions currently remains unresolved. There is currently no “gold standard” for pain relief after total hip and knee replacement surgeries. An excellent ratio of effectiveness and safety is demonstrated by multimodal pain relief programs based on peripheral nerve blocks. However, while having undeniable advantages, conduction anesthesia/analgesia has a critically important drawback. The cornerstone of postoperative rehabilitation for patients undergoing total hip or knee replacement is their early activation. All methods of conduction anesthesia are associated with motor blockade. In particular, femoral nerve block causes weakness of quadriceps muscle of thigh, inducing patients’ inadvertent falling when attempting to stand or walk. The situation with the choice of the method of anesthesia after total replacement of the lower limb large joints can be described as “a long way to go”.

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Early mobilization after total hip or knee arthroplasty: a substudy of the POWER.2 study

Cited by 4 publications

References 22 publications

Anterior Approach to Hip Arthroplasty with Early Mobilization Key for Reduced Hospital Length of Stay

Anterior Approach to Hip Arthroplasty with Early Mobilization Key for Reduced Hospital Length of Stay

Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol

The difficulty of choosing the method of analgesia after total replacement of the lower limb large joints (case report, literature review)

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