Implementation of Ireland's first state-funded day-case total hip arthroplasty programme

Area of Science:

• Orthopaedic Surgery
• Anaesthesiology
• Healthcare Management

Background:

• Enhanced recovery protocols have enabled many elective procedures to become day-case surgeries.
• Total hip arthroplasty (THA) was previously considered unsuitable for day-case surgery due to expected pain and recovery.
• The National Orthopaedic Hospital Cappagh pioneered Ireland's first public day-case THA service in June 2018.

Purpose of the Study:

• To outline a day-case total hip arthroplasty pathway.
• To detail anaesthetic considerations for day-case THA.
• To report on the success rates of same-day discharge and readmission for day-case THA.

Main Methods:

• Implementation of a day-case total hip arthroplasty pathway.
• Focus on specific anaesthetic management strategies.
• Retrospective review of 109 consecutive cases.

Main Results:

• Successful same-day discharge was achieved in 90.8% of the first 109 cases.
• The readmission rate was 4.6%.
• The pathway proved highly positive and met expectations.

Conclusions:

• Day-case total hip arthroplasty is a safe and beneficial option for patients and healthcare systems.
• Appropriate patient selection and comprehensive education are crucial for success.
• This pathway demonstrates the feasibility and advantages of day-case THA in a public hospital setting.