Day-case Total Hip Arthroplasty: a Literature Review and Development of a Hospital Pathway

Overview

Journal Bone Jt Open

Date 2021 Feb 12

PMID 33573396

Citations 7

Authors

Joshua W Thompson

Warran Wignadasan

Mazin Ibrahim

Lucy Beasley

Sujith Konan

Ricci Plastow

Ahmed Magan

Fares S Haddad

Affiliations

Soon will be listed here.

Abstract

Aims: We present the development of a day-case total hip arthroplasty (THA) pathway in a UK National Health Service institution in conjunction with an extensive evidence-based summary of the interventions used to achieve successful day-case THA to which the protocol is founded upon.

Methods: We performed a prospective audit of day-case THA in our institution as we reinitiate our full capacity elective services. In parallel, we performed a review of the literature reporting complication or readmission rates at ≥ 30-day postoperative following day-case THA. Electronic searches were performed using four databases from the date of inception to November 2020. Relevant studies were identified, data extracted, and qualitative synthesis performed.

Results: Our evaluation and critique of the evidence-based literature identifies day-case THA to be safe, effective, and economical, benefiting both patients and healthcare systems alike. We further validate this with our institutional elective day surgery arthroplasty pathway (EDSAP) and report a small cohort of successful day-case THA cases as an example in the early stages of this practice in our unit.

Conclusion: Careful patient selection and education, adequate perioperative considerations, including multimodal analgesia, surgical technique and blood loss management protocols and appropriate postoperative pathways comprising reliable discharge criteria are essential for successful day-case THA. Cite this article: 2021;2(2):93-102.

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References

Otero J, Gholson J, Pugely A, Gao Y, Bedard N, Callaghan J . Length of Hospitalization After Joint Arthroplasty: Does Early Discharge Affect Complications and Readmission Rates?. J Arthroplasty. 2016; 31(12):2714-2725. DOI: 10.1016/j.arth.2016.07.026. View

Yoon R, Nellans K, Geller J, Kim A, Jacobs M, Macaulay W . Patient education before hip or knee arthroplasty lowers length of stay. J Arthroplasty. 2009; 25(4):547-51. DOI: 10.1016/j.arth.2009.03.012. View

Madsen M, Kirkegaard M, Laursen M, Larsen J, Pedersen M, Skovgaard B . Low complication rate after same-day total hip arthroplasty: a retrospective, single-center cohort study in 116 procedures. Acta Orthop. 2019; 90(5):439-444. PMC: 6746288. DOI: 10.1080/17453674.2019.1637631. View

Higuera C, Elsharkawy K, Klika A, Brocone M, Barsoum W . 2010 Mid-America Orthopaedic Association Physician in Training Award: predictors of early adverse outcomes after knee and hip arthroplasty in geriatric patients. Clin Orthop Relat Res. 2011; 469(5):1391-400. PMC: 3069283. DOI: 10.1007/s11999-011-1804-3. View

Dorr L, Thomas D, Zhu J, Dastane M, Chao L, Long W . Outpatient total hip arthroplasty. J Arthroplasty. 2009; 25(4):501-6. DOI: 10.1016/j.arth.2009.06.005. View

Ibrahim M, Twaij H, Giebaly D, Nizam I, Haddad F . Enhanced recovery in total hip replacement: a clinical review. Bone Joint J. 2013; 95-B(12):1587-94. DOI: 10.1302/0301-620X.95B12.31303. View

Horriat S, Hamilton P, Sott A . Financial aspects of arthroplasty options for intra-capsular neck of femur fractures: a cost analysis study to review the financial impacts of implementing NICE guidelines in the NHS organisations. Injury. 2014; 46(2):363-5. DOI: 10.1016/j.injury.2014.05.014. View

Klein G, Posner J, Levine H, Hartzband M . Same Day Total Hip Arthroplasty Performed at an Ambulatory Surgical Center: 90-Day Complication Rate on 549 Patients. J Arthroplasty. 2016; 32(4):1103-1106. DOI: 10.1016/j.arth.2016.10.013. View

Toy P, Fournier M, Throckmorton T, Mihalko W . Low Rates of Adverse Events Following Ambulatory Outpatient Total Hip Arthroplasty at a Free-Standing Surgery Center. J Arthroplasty. 2017; 33(1):46-50. DOI: 10.1016/j.arth.2017.08.026. View

10.

Berend K, Lombardi Jr A, Berend M, Adams J, Morris M . The outpatient total hip arthroplasty : a paradigm change. Bone Joint J. 2018; 100-B(1 Supple A):31-35. PMC: 6424444. DOI: 10.1302/0301-620X.100B1.BJJ-2017-0514.R1. View

11.

Bordoni V, Marelli N, Previtali D, Gaffurini P, Filardo G, Candrian C . Outpatient total hip arthroplasty does not increase complications and readmissions: a meta-analysis. Hip Int. 2020; 32(3):326-333. DOI: 10.1177/1120700020948797. View

12.

Coenders M, Mathijssen N, Vehmeijer S . Three and a half years' experience with outpatient total hip arthroplasty. Bone Joint J. 2020; 102-B(1):82-89. DOI: 10.1302/0301-620X.102B1.BJJ-2019-0045.R2. View

13.

Learmonth I, Young C, Rorabeck C . The operation of the century: total hip replacement. Lancet. 2007; 370(9597):1508-19. DOI: 10.1016/S0140-6736(07)60457-7. View

14.

Maempel J, Clement N, Ballantyne J, Dunstan E . Enhanced recovery programmes after total hip arthroplasty can result in reduced length of hospital stay without compromising functional outcome. Bone Joint J. 2016; 98-B(4):475-82. DOI: 10.1302/0301-620X.98B4.36243. View

15.

Goyal N, Chen A, Padgett S, Tan T, Kheir M, Hopper Jr R . Otto Aufranc Award: A Multicenter, Randomized Study of Outpatient versus Inpatient Total Hip Arthroplasty. Clin Orthop Relat Res. 2016; 475(2):364-372. PMC: 5213925. DOI: 10.1007/s11999-016-4915-z. View

16.

Keulen M, Asselberghs S, Boonen B, Hendrickx R, Van Haaren E, Schotanus M . Predictors of (Un)successful Same-Day Discharge in Selected Patients Following Outpatient Hip and Knee Arthroplasty. J Arthroplasty. 2020; 35(8):1986-1992. DOI: 10.1016/j.arth.2020.03.034. View

17.

Aynardi M, Post Z, Ong A, Orozco F, Sukin D . Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study. HSS J. 2014; 10(3):252-5. PMC: 4171452. DOI: 10.1007/s11420-014-9401-0. View

18.

Richards M, Alyousif H, Kim J, Poitras S, Penning J, Beaule P . An Evaluation of the Safety and Effectiveness of Total Hip Arthroplasty as an Outpatient Procedure: A Matched-Cohort Analysis. J Arthroplasty. 2018; 33(10):3206-3210. DOI: 10.1016/j.arth.2018.05.036. View

19.

Berger R, Sanders S, Thill E, Sporer S, Della Valle C . Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop Relat Res. 2009; 467(6):1424-30. PMC: 2674175. DOI: 10.1007/s11999-009-0741-x. View

20.

Patel A, Pavlou G, Mujica-Mota R, Toms A . The epidemiology of revision total knee and hip arthroplasty in England and Wales: a comparative analysis with projections for the United States. A study using the National Joint Registry dataset. Bone Joint J. 2015; 97-B(8):1076-81. DOI: 10.1302/0301-620X.97B8.35170. View