Key result
A time-based, patient-centered fast-track program for direct anterior approach total hip arthroplasty resulted in an average length of stay of 26 hours and a 3-month complication rate of 6%.
Why the study?
Does a time-based patient-centered fast-track program for DAA total hip arthroplasty achieve a 24-hour length of stay with acceptable safety in patients without complicated medical comorbidities?
Cohort (n=378)
No
Does a time-based patient-centered fast-track program for DAA total hip arthroplasty achieve a 24-hour length of stay with acceptable safety in patients without complicated medical comorbidities?
A time-based, patient-centered fast-track program for direct anterior approach total hip arthroplasty can achieve a standardized length of stay of about 24 hours with low complication and readmission rates.
Supports 24-hour DAA THA discharge in selected low-risk patients; leaves open generalizability to broader populations.
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.
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Eeden et al. (2016) conducted a cohort in Total hip arthroplasty (n=378). Time-based patient-centered primary direct anterior approach (DAA) total hip arthroplasty (THA) treatment protocol was evaluated on Length of stay and complication rate at discharge and 90 days postoperatively. A time-based, patient-centered fast-track program for direct anterior approach total hip arthroplasty resulted in an average length of stay of 26 hours and a 3-month complication rate of 6%.
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