Navigation Links
Study shows fast track total hip replacement surgery is effective and safe
Date:6/30/2011

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 study were discharged with aspirin.

Patients on the fast track protocol had a physical therapy session on the day of their surgery. The main difference was that a patient's pain medication was discontinued in the fast track cohort postoperative day one (as long as pain was deemed to be under control), whereas in the traditional cohort, pain medication is usually discontinued on day two.

Patients in both cohorts were sent home with aspirin, an arrangement for work with a physical therapist, a patient management plan including a list of daily goals, and nausea and pain control plans. A study coordinator screened for complications one day and one week after discharge.

The investigators found that 58 percent of the fast track cohort was discharged within two days of a THR and 73 percent were discharged within three days. The average discharge time was 2.6 days in the fast track cohort and 4.1 in the traditional cohort. Patients were less likely to be discharged rapidly in the fast track cohort, if they had significant post-operative pain, nausea, or dizziness. At one year, there were no differences in complications, readmissions or reoperation in the two cohorts.

"For a select group of patients, we have shown that a two day discharge is safe and feasible for patients undergoing a total hip replacement," Dr. Nestor said. He pointed out that the two day fast track is not for higher risk patients, the ones who were excluded from the study. While the authors did not measure if the fast track protocol saves money, since it involves shortened hospital stays, the researchers expect it to.

Roughly half a million THRs are conducted every year in the United States, and this number is expected to grow. Many in the baby boomer generation are not willing to be sedentary and as their joints age, they are demanding joint replacement surgeries to keep active.


'/>"/>

Contact: Phyllis Fisher
phyllis.fisher@gmail.com
212-606-1197
Hospital for Special Surgery
Source:Eurekalert

Related medicine news :

1. Allina receives NIH grant to study real world usage of integrative therapies
2. Study uncovers novel genetic variation linked to increased risk of sudden cardiac arrest
3. BMC conducts high rates of thyroid testing in pregnant women, study finds
4. Cotton Swabs Help Prevent Surgical Site Infections: Study
5. Wake Forest Baptist conducts clinical study for insomnia using new technology
6. E-Prescribing Doesnt Slash Errors, Study Finds
7. Study on football: Women get up faster
8. Obesity a Major Cause of Early Death in Women: Study
9. Rutgers study: Third of N.J. immigrant children, many adult newcomers lack health insurance
10. Workplace mental health disability leave recurs sooner than physical health leave, CAMH study shows
11. Preventing Type 2 Diabetes Saves Money: Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/10/2016)... St. Louis, Missouri (PRWEB) , ... February 10, ... ... 11-14, 2016, in San Diego, will bring together more than 200 of the ... in healthcare for the future. , “The true benefit of the Forum is ...
(Date:2/10/2016)... ... 10, 2016 , ... AHRA: The Association for Medical Imaging ... Fox will serve as keynote speaker at the organization’s 2016 Spring Conference. Fox’s ... more effectively communicate with their own organizational staff and leadership. , “I ...
(Date:2/10/2016)... ... February 10, 2016 , ... Everseat has joined the award-winning ... to physicians. The integration will enable Allscripts users to post open appointments to ... mobile app. , The partnership gives Everseat substantial added power to help Allscripts ...
(Date:2/10/2016)... ... February 10, 2016 , ... The recreational use of marijuana has been ... still face a lot of restrictions as to where they can smoke pot. ... use” and that cannabis “may not be consumed openly or publicly.” , Given the ...
(Date:2/10/2016)... ... February 09, 2016 , ... According to a recent article published ... number of patients under the age of 30. According to Southern California based medical ... and may indicate an overall shift in the rapidly growing social acceptance of cosmetic ...
Breaking Medicine News(10 mins):
(Date:2/10/2016)... , February 10, 2016 ... new market research report "Pharmaceutical Packaging Equipment Market by ... Labeling & Serialization), by Product Type (Tablet, Powder, Cream, ... published by MarketsandMarkets, studies the global market during the forecast ... to grow at a CAGR of 6.9% during the ...
(Date:2/10/2016)... On Tuesday, February 9th, the U.S. ... its Arthritis Advisory Committee to discuss Celltrion,s ... Johnson,s Remicade and most likely the second ... The Biologics Prescribers Collaborative (BPC) along with ... Patient Access, American Association of Clinical Endocrinologists, ...
(Date:2/10/2016)... 10, 2016 --> ... Therapeutics and Companion Diagnostic Market to 2019 - ... Environment" research report indicates that the core personalized ... by 2020 growing at a CAGR of 8.74%. ... and targeted therapeutics and is dominated by oncology, ...
Breaking Medicine Technology: