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Outcomes of outpatient total hip arthroplasty: a systematic review
Jacob Shapira1, Sarah L Chen2, Philip J Rosinsky1
1American Hip Institute Research Foundation, Des Plaines, IL, USA.
Insights
Outpatient total hip arthroplasty (THA) shows excellent functional outcomes and low short-term readmission rates in patients without significant comorbidities. This approach is a safe and effective option for hip replacement surgery.
Area of Science:
- Orthopedic Surgery
- Arthroplasty
- Patient Outcomes
Background:
- Total hip arthroplasty (THA) is increasingly being performed in an outpatient setting.
- This trend mirrors shifts seen in other total joint replacement procedures.
Purpose of the Study:
- To analyze the functional outcomes and readmission rates following outpatient total hip arthroplasty (THA).
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, and Cochrane databases in April 2019.
- The search adhered to PRISMA guidelines, identifying studies reporting functional outcomes of outpatient THA.
- Nine articles, encompassing 683 hips and data from 1988-2016, were included in the analysis.
Main Results:
- Excellent average Harris Hip Scores (>90) were reported by 6 weeks postoperatively in most studies.
- Significant improvements in pain scores (VAS and NRS) were observed.
- High same-day discharge rates (88.1%) and a low readmission rate (0.34% within 3 months) were documented.
Conclusions:
- Outpatient THA demonstrates favorable short-term outcomes for patients without significant comorbidities.
- Low readmission rates support the safety and efficacy of same-day discharge protocols for selected THA patients.
Introduction:
Similar to other total joint arthroplasty procedures, total hip arthroplasty (THA) is shifting to an outpatient setting. The purpose of this study was to analyse outcomes following outpatient THA.
Methods:
A comprehensive literature search was performed in April 2019 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines using the PubMed, Embase, and Cochrane databases to identify articles that reported functional outcomes following outpatient total hip arthroplasty (THA).
Results:
9 articles, with 683 hips and a collective study period of 1988 to 2016, were included in this analysis. The mean age across all studies was 58.9 years and the follow-up period ranged from 4 weeks to 10 years. 4 studies reported Harris Hip Scores (HHSs) for their patient populations and in 3 studies, the average HHSs were excellent (>90) by 6 weeks postoperatively. The fourth study reported fair HHS scores for the outpatient and inpatient THA groups (75 ± 18, 75 ± 14, p = 0.77, respectively) at 4 weeks postoperatively. VAS scores improved significantly in two studies and NRS at rest and during activity improved significantly (p < 0.001) in a separate study. Overall, 88.1% of the enrolled patients were discharged the same day of surgery, as expected. Out of the 6 studies reporting on readmissions rate, there were two (0.34%) readmissions within 3 months of surgery.
Conclusion:
In patients with no significant comorbidities, outpatient THA leads to favourable outcomes as well as low readmission rates in the short term.
