Enhanced recovery programmes after total hip arthroplasty can result in reduced length of hospital stay without compromising functional outcome
2016
Aims The primary aim of this study was to investigate the effect of
an enhanced recovery program (ERP) on the short-term functional
outcome after total hip arthroplasty (THA). Secondary outcomes included
its effect on rates of dislocation and mortality. Patients and Methods Data were gathered on 1161 patients undergoing primary THA which
included 611 patients treated with traditional rehabilitation and
550 treated with an ERP. Results The ERP was shown to be a significant independent factor which
shortened length of stay (LOS) by a mean of 1.5 days (95% confidence
interval (CI) 1.3 to 1.8, p < 0.001) after adjusting for confounding
variables. The rates of dislocation (traditional 1.03% vs ERP
0.91%, p = 0.84) and mortality (1.5% vs 0.6%, p = 0.14)
one year post-operatively were not significantly different. Both
groups showed significant improvement in Harris Hip Score (42.8 vs 41.5)
at 12 to 18 months post-operatively and there was no significant
difference in the magnitude of improvement on univariate (p = 0.09)
and multivariate analysis (p = 0.35). There was no significant difference
in any of the eight domain scores of the Short-Form - 36 general
health surveys post-operatively (p > 0.38). Conclusion We conclude that an ERP after THA shortens LOS by a mean of 1.5
days and does not increase the rate of complications post-operatively.
It gives equivalent functional outcomes to a traditional rehabilitation
pathway. Take home message: ERP reduces LOS after THA in comparison to
traditional rehabilitation, without adversely affecting functional
outcomes, dislocation rates or mortality. Cite this article: Bone Joint J 2016;98-B:475–82.
Keywords:
- Correction
- Source
- Cite
- Save
- Machine Reading By IdeaReader
48
References
42
Citations
NaN
KQI