Optimizing Early Recovery Quality in Same-Day Discharge Total Hip Arthroplasty: A Narrative Review

The paradigm of total hip arthroplasty (THA) is undergoing a transformative shift from prolonged inpatient care toward same-day discharge (SDD), driven by the convergence of enhanced recovery after surgery (ERAS) protocols, advances in anesthesia and analgesia, and evolving reimbursement policies. As global demand for THA continues to escalate amid population ageing, this model offers a compelling strategy to optimize healthcare resource utilization without compromising patient safety. However, the success of SDD-THA depends on a precise understanding of early postoperative recovery quality, which is a multidimensional construct encompassing pain control, functional restoration, hemodynamic stability, and patient-reported well-being. This review synthesizes contemporary evidence on early recovery trajectories and the multifactorial determinants that govern them. We analyze critical clinical strategies, including evidence-based patient selection, perioperative ERAS protocol implementation, anesthetic and multimodal analgesic optimization, blood management and complication prevention, early rehabilitation paradigms, and the influence of healthcare policy and economic frameworks on early recovery quality. By integrating these domains, we propose a patient-centered quality improvement pathway that prioritizes the velocity of functional independence as the definitive clinical endpoint. Focusing on these core perioperative optimizations ensures a sustainable, high-value SDD-THA practice.