Advertisement

Feasibility of day-case total hip arthroplasty: a single-centre observational study

Feasibility of day-case total hip arthroplasty: a single-centre observational study

Hip Int 2017; 27(1): 60 - 65

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/hipint.5000421

Authors

Jens Rolighed Larsen, Birgitte Skovgaard, Thomas Prynø, Laimonas Bendikas, Lone R. Mikkelsen, Malene Laursen, Mette T. Høybye, Søren Mikkelsen, Lene Bastrup Jørgensen

Abstract

Introduction

Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge.

Methods

Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study. THA was managed as day-case (<12 hours) through patient selection, preoperative patient education programme, light spinal anaesthesia, low opioid usage, and early mobilisation. Efficacy and logistics were analysed and compared to current accelerated practice. Patient satisfaction was compared to existing fast-track THA and elective surgery cohorts.

Results

29 consecutive patients were screened and 20 participated (69%). 17/20 patients (85%) were released on the day of surgery. There were no serious adverse events or complications, and no infections or readmission at 6-week follow-up. Patient overall satisfaction rating (1-5) was high (4.75), higher than in a 301-patient cohort (4.53) (THA and total knee arthroplasty) from the same centre (p = 0.23), and higher than in a national, elective surgery cohort (4.3) (p = 0.04).

Conclusions

We report the feasibility of day-case THA. Safety, complications and overall patient acceptance were satisfactory. Light spinal anaesthesia facilitated quick transit through postanaesthesia care unit to early mobilisation. Support persons and patient education may play a part in high patient acceptance of day-case surgery.

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.

Authors

Affiliations

  •  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark
  •  Institute for Clinical Medicine, Aarhus University Hospital, Aarhus - Denmark

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.