24 hours stay after hip replacement

Abstract

Background and purpose — The length of stay after total hip arthroplasty has been reduced to 2–4 days after implementing fast-track surgery. We investigated whether a new time-based patient-centered primary direct anterior approach (DAA) total hip arthroplasty (THA) treatment protocol in a specialized clinic, with a planned length of stay of about 24 hours, could be achieved in all patients or only in a selected group of patients.Patients and methods — We analyzed prospectively collected data in a cohort of 378 consecutive patients who underwent a primary direct anterior THA as a patient-centered time-based procedure between March 1, 2012 and December 31, 2015. Patients with complicated medical comorbidity and those over the age of 85 were excluded from the study. The average length of stay was recorded and all complications, re-admissions, and reoperations were registered and analyzed. The primary outcome measures were length of stay and complication rate, at discharge and 90 days postoperatively.Results — The average length of stay for all patients was 26 hours. All patients were discharged from the clinic on the day after the operation and were able to continue their recovery at home or in a rehabilitation facility. The overall complication rate within 3 months of surgery was 6%. The 3-month re-admission rate and the 3-month reoperation rate were both 2%.Interpretation — Performing a time-based, patient-centered fast-track program for DAA total hip arthroplasty can result in a standardized length of stay of about 24 hours and a high level of patient satisfaction with few complications, re-admissions, and reoperations.

Anesthesia for the patient undergoing total knee replacement: current status and future prospects

“…Studies have also demonstrated a decrease in postoperative cognitive delirium with fast tracked patient populations, as well as a more rapid time to discharge 51,52. Additionally, these interventions have been shown to decrease thromboembolic complications and patient readmissions 53.…”

Does walking the day of total hip arthroplasty speed up functional independence? A non-randomized controlled study

“…Consequently, fear of movement reduction represents an interdisciplinary goal in patients who undergo THA [28]. Moreover, awareness to have improved health status and that pain was not a limiting factor for mobilization might have also contributed to enhance patients' functional independence after WDS [30,31]. In fact, the approach adopted in SG might have increased the use of affected limb in functional activies, reducing adaptive stategies with the nonaffected limb and functional dependence on healthcare personnel and caregivers [32].…”

Using the anterior capsule of the hip joint to protect the tensor fascia lata muscle during direct anterior total hip arthroplasty: a randomized prospective trial

“…Moreover, this approach is favored because it provides adequate exposure of the acetabular side [1][2][3][4][5]. Several studies have reported that DAA decreases the duration of hospital stay and increases the percentage of patients discharged home due to the lesser operative trauma which permits a more rapid recovery [5][6][7][8][9]. Whether DAA is actually superior to other surgical approaches, however, remains controversial.…”