Similar Outcomes After Hospital-Based Same-Day Discharge vs Inpatient Total Hip Arthroplasty

There has been increasing interest in performing primary hip and knee replacement with same-day discharge (SDD). The purpose of this study is to compare patient-reported outcome (PRO) scores, pain scores, and readmissions in patients who underwent SDD total hip arthroplasty (THA) with those in patients who underwent traditional inpatient THA.

A retrospective study was conducted on 963 patients who underwent primary THA at our institution between September 2016 and December 2018. Two cohorts were established based on whether the patient underwent SDD or traditional inpatient THA. An electronic physical engagement application was used to collect PRO scores (Hip Disability and Osteoarthritis Outcome Score for Joint Replacement, Veterans Rand 12-Item Health Survey Physical Component Score, and Mental Component Score) and pain scores. To control for demographic variables, a multiple regression analysis of PRO scores was conducted.

Four hundred fifteen (43.1%) patients in this study underwent the SDD protocol. There were significant differences between both cohorts with respect to sex, age, body mass index, American Society of Anesthesiologists score, and smoking status. The bivariate analysis revealed that the SDD cohort had a significantly greater change in the Veterans Rand 12-Item Health Survey Physical Component Score and had fewer readmissions. Both cohorts had equivalent decreases in pain scores. After controlling for demographic variables in a multivariable analysis, the SDD cohort was found to have higher PRO scores at all time points, but there were no significant differences in the change in PRO scores over time between both groups.

Patients in an SDD THA care pathway experienced similar improvements in PRO scores and clinically equal reduction in pain scores.