Easily adoptable total joint arthroplasty program allows discharge home in two days

Area of Science:

• Orthopedic Surgery
• Healthcare Management
• Patient Care Pathways

Background:

• Increasing demand for arthroplasty surgery in Canada necessitates efficient and safe care models.
• Traditional care pathways may not optimally address the growing volume of joint replacement procedures.

Purpose of the Study:

• To evaluate the effectiveness of a fast-track care model in reducing hospital length of stay for total hip and knee arthroplasty.
• To assess patient safety and satisfaction outcomes associated with the fast-track arthroplasty program.

Main Methods:

• A historical cohort study compared 100 patients in a fast-track program with 100 patients from a standard care program.
• The fast-track program incorporated preoperative education, multimodal analgesia, early rehabilitation, and outpatient follow-up.
• Outcomes included length of stay, postoperative side effects, transfers, and 30-day emergency department visits and readmissions.

Main Results:

• The fast-track program significantly reduced hospital length of stay (mean 47 hours vs. 116 hours) compared to the standard program.
• Patients in the fast-track group were discharged 69 hours earlier, with lower opioid consumption and comparable pain scores.
• No significant differences were observed in emergency department visits or 30-day readmission rates between the groups.

Conclusions:

• A multimodal, multidisciplinary fast-track protocol effectively reduces hospital stay and opioid consumption in arthroplasty patients.
• The fast-track model maintains a high level of patient safety and is feasible for implementation in various hospital settings.