Does Surgical Approach to the Hip Play a Role in Same-Day Discharge Outcomes?

Area of Science:

• Orthopedic Surgery
• Arthroplasty
• Patient Outcomes

Background:

• Same-day-discharge (SDD) in total hip arthroplasty (THA) is increasingly explored.
• Different surgical approaches may influence SDD success.

Purpose of the Study:

• To compare the success of SDD for THA based on surgical approach (direct anterior vs. posterior).
• To evaluate the impact of surgical approach on patient outcomes and complications.

Main Methods:

• Retrospective analysis of 1,334 patients undergoing elective primary THA enrolled in an SDD program (2015-2020).
• Patients were grouped by direct anterior approach (n=1,127) or posterior approach (n=207).
• Primary outcome: failure-to-launch (hospital stay > 1 midnight); secondary outcomes: patient-reported scores, readmission, revision, and surgical time.

Main Results:

• Posterior approach had higher failure-to-launch rates (12.1% vs. 5.9%, P=.002) and longer surgical times (99 vs. 80 min, P<.001) than direct anterior approach.
• Readmission (1.7% vs. 1.4%) and revision rates (1% vs. 1%) were similar between groups.
• Hip Disability and Osteoarthritis Outcome Score improvements were comparable at 12 months (35.3 vs. 34.5).

Conclusions:

• Patient selection and surgical approach are crucial for successful SDD in THA.
• Surgical approach did not significantly affect 90-day readmission, revision rates, or patient-reported outcomes in the first year post-THA.