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Three and a half years' experience with outpatient total hip arthroplasty
Michel J Coenders1, Nina M C Mathijssen1, Stephan B W Vehmeijer1
1Department of Orthopaedic Surgery, Reinier de Graaf Hospital, Delft, The Netherlands.
Insights
Outpatient total hip arthroplasty (THA) is safe and effective for selected patients. This approach shows significant improvements in patient outcomes without increased complications or readmissions.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Patient Outcomes
Background:
- Total hip arthroplasty (THA) is a common procedure.
- Outpatient THA is an emerging trend aiming to improve efficiency and patient satisfaction.
Purpose of the Study:
- To evaluate the safety and efficacy of outpatient total hip arthroplasty (THA).
- To assess patient-reported outcomes and complications in an outpatient THA setting.
Main Methods:
- Prospective cohort study of patients undergoing primary THA via anterior approach.
- Data collection included patient demographics, surgical details, and patient-reported outcome measures (PROMs) at multiple time points.
- Monitoring of complications, readmissions, and reoperations.
Main Results:
- 217 out of 257 eligible patients (84.4%) were discharged on the day of surgery.
- Significant improvements in hip-related PROMs were observed up to 12 months postoperatively.
- No complications directly related to the outpatient THA protocol were reported.
Conclusions:
- Outpatient THA is a safe and successful option for carefully selected patients.
- The procedure leads to satisfying patient outcomes with minimal readmissions or reoperations.
- This approach demonstrates feasibility without compromising patient safety or recovery.
Aims:
The aim of this study was to report our experience at 3.5 years with outpatient total hip arthroplasty (THA).
Methods:
In this prospective cohort study, we included all patients who were planned to receive primary THA through the anterior approach between 1 April 2014 and 1 October 2017. Patient-related data and surgical information were recorded. Patient reported outcome measures (PROMs) related to the hip and an anchor question were taken preoperatively, at six weeks, three months, and one year after surgery. All complications, readmissions, and reoperations were registered.
Results:
Of the 647 THA patients who had surgery in this period through the anterior approach, 257 patients (39.7%) met the inclusion criteria and were scheduled for THA in an outpatient setting. Of these, 40 patients (15.6%) were admitted to the hospital, mainly because of postoperative nausea and/or dizziness. All other 217 patients were able to go home on the day of surgery. All hip-related PROMs improved significantly up to 12 months after surgery, compared with the scores before surgery. There were three readmissions and two reoperations in the outpatient cohort. There were no complications related to the outpatient THA protocol.
Conclusion:
These study results confirm that outpatient THA can be performed safe and successfully in a selected group of patients, with satisfying results up to one year postoperatively, and without outpatient-related complications, readmissions, and reoperations. Cite this article: Bone Joint J 2020;102-B(1):82-89.
