Relationship between length of stay and dislocation rate after total hip arthroplasty

Mauerhan, David R.; Lonergan, Robert P; Mokris, Jeffrey G.; Kiebzak, Gary M.

doi:10.1016/s0883-5403(03)00334-6

Cited by 36 publications

(28 citation statements)

References 22 publications

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“…The relationship that these complications have with a shortened hospital stay is uncertain. Previous authors have suggested that a shortened hospital stay is associated with a higher dislocation rate; however, this did not reach significance in the present study [13]. …”

Section: Discussioncontrasting

confidence: 98%

Fast Track THR: One Hospital's Experience with a 2-Day Length of Stay Protocol for Total Hip Replacement

et al. 2011

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BackgroundCurrent trends in total joint replacement have focused on shorter hospital stays.PurposeThis study aimed to determine if a pathway for total hip replacement (THR) with the goal of a 2-day discharge (fast track) is safe and effective compared to our traditional pathway (control).MethodsOne hundred forty-nine patients undergoing unilateral, uncomplicated, THR were enrolled in an accelerated postoperative pathway and 134 were enrolled in the traditional pathway. Patients were followed prospectively and outcomes included hospital length of stay, intra- and postoperative complications, readmissions, reoperations. A statistical model was created to determine factors predictive of a 2-day discharge.ResultsAt 1 year, there were no differences in complications, readmissions, or reoperations. The average length of stay decreased from 4.1 to 2.6 days (p < 0.0001). In the fast track group, 58% of patients were discharged home within 2 days. Barriers to a 2-day discharge were postoperative pain, nausea, and dizziness. The only preoperative factor that was predictive of a 2-day discharge was hypertension.ConclusionsIn a select group of patients, a protocol that allows for a 2-day discharge following THR is safe and effective.

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Section: Discussioncontrasting

confidence: 98%

Fast Track THR: One Hospital's Experience with a 2-Day Length of Stay Protocol for Total Hip Replacement

et al. 2011

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“…We cannot confirm a previous report of increased risk of hip dislocation associated with a reduction in LOS (Mauerhan et al 2003), as we had a dislocation rate of only 2%. 10 of 19 re-admissions after TKA were under suspicion of DVT or infection, which were not found.…”

Section: Discussioncontrasting

confidence: 97%

Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: Fast-track experience in 712 patients

2008

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Background and purposeVery few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction after total hip and knee replacement surgery.Patients and methods Between September 2003 and December 2005, 712 consecutive, unselected patients (440 women) with a mean age of 69 (31-91) years were admitted for hip and knee replacement surgery at our specialized fast-track joint replacement unit. Epidemiological, physical, and perioperative parameters were registered and correlated to LOS and patient satisfaction.Results 92% of the patients were discharged directly to their homes within 5 days, and 41% were discharged within 3 days. Age, sex, marital status, co-morbidity, preoperative use of walking aids, pre-and postoperative hemoglobin levels, the need for blood transfusion, ASA score, and time between surgery and mobilization, were all found to influence postoperative outcome in general, and LOS and patient satisfaction in particular.Interpretation We identified several patient characteristics that influence postoperative outcome, LOS, and patient satisfaction in our series of consecutive fast-track joint replacement patients, enabling further attention to be paid to certain aspects of surgery and rehabilitation.

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“…It has been suggested shorter hospital stays may be associated with more frequent dislocations as a result of less patient supervision and subsequent poor compliance [79]. Although the majority of dislocations in that study occurred after discharge, there was no correlation between length of stay and dislocation rate [79].…”

Section: Hip Precautionsmentioning

confidence: 70%

“…The rate of dislocation varies from 0.5% to 11.2% [4,22,44,51,71,77,79,83,122,134,135]. Various factors contribute to a dislocation, including surgical technique, surgical skill, the type of prosthesis, alignment, surgical approach, revision surgery, and a history of neuromuscular disorders [4,22,35,77,82,134].…”

Section: Hip Precautionsmentioning

confidence: 99%

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Myths and Legends in Orthopaedic Practice: Are We All Guilty?

Tejwani

Immerman

2008

Clinical Orthopaedics &Amp; Related Research

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Over years of practice, many beliefs and practices become entrenched as tried and tested, and we subconsciously believe they are based on scientific evidence. We identified nine such beliefs by interviewing orthopaedic surgeons in which studies (or lack thereof) apparently do not support such practices. These are: changing the scalpel blade after the skin incision to limit contamination; bending the patient's knee when applying a thigh tourniquet; bed rest for treatment of deep vein thrombosis; antibiotics in irrigation solution; routine use of hip precautions; routine use of antibiotics for the duration of wound drains; routine removal of hardware in children; correlation between operative time and infection; and not changing dressings on the floor before scrubbing. A survey of 186 practicing orthopaedic surgeons in academic and community settings was performed to assess their routine practice patterns. We present the results of the survey along with an in-depth literature review of these topics. Most surgeon practices are based on a combination of knowledge gained during training, reading the literature, and personal experience. The results of this survey hopefully will raise the awareness of the selected literature for common practices.

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Relationship between length of stay and dislocation rate after total hip arthroplasty

Cited by 36 publications

References 22 publications

Fast Track THR: One Hospital's Experience with a 2-Day Length of Stay Protocol for Total Hip Replacement

Fast Track THR: One Hospital's Experience with a 2-Day Length of Stay Protocol for Total Hip Replacement

Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: Fast-track experience in 712 patients

Myths and Legends in Orthopaedic Practice: Are We All Guilty?

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