Fast Track Total Hip Replacement Surgery Is Effective and Safe
NEW YORK, July 1, 2011 /PRNewswire/ -- Generally healthy patients who undergo total hip replacement (THR) can be fast tracked to be discharged in two days compared with the standard three to six days, according to a new study by researchers at Hospital for Special Surgery (HSS) in New York City. The study could help cut down on hospital-acquired infections, reduce hospital costs and improve patient satisfaction.
"Before this study, we were uncertain how safe it would be to discharge patients within two days after a total hip replacement, but based on this study, we now know that it is safe. This is evidenced by the fact that the patients who were discharged within two days did not have an increase in complications, readmissions or reoperations," said Lawrence Gulotta, M.D., an orthopedic surgeon at HSS and first author of the study. "This is something that can help improve health care costs and provide better care for our patients by keeping them out of the hospital." Bryan Nestor, M.D., an orthopedic surgeon in Adult Reconstruction and Joint Replacement Service at HSS, was principal investigator of the study.
The prospective study that will be reported in an upcoming issue of Springer's HSS Journal compared outcomes of patients undergoing THR at HSS between 2004 and 2008. One cohort of 149 patients underwent THR with a fast track protocol. The other cohort of 134 patients underwent THR followed by the hospital's traditional clinical pathway, which aimed to discharge patients at four days at that time.
Patients in the two cohorts were matched for age, sex, body mass index, and comorbidities. Patients were excluded if they had inflammatory arthritis, complex THR, and medical comorbidities such as a history of a myocardial infarction, pulmonary embolism or deep vein thrombosis. Blood clots can be a complication of THR, and patients with a history of these comorbidities cannot be treated with simple aspirin consumption. All patients in the