No complications seen in study of same-day discharge total hip arthroplasty

Nearly all patients who underwent a minimally invasive, computer-assisted total hip procedure with same-day discharge would recommend it to others.

ASHEVILLE, N.C. — An investigation into a same-day discharge protocol for total hip arthroplasty has revealed it to be safe in selected patients under the age of 65 years.

In a poster study presented here at the 120th annual meeting of the American Orthopaedic Association, Debra J. Thomas, MD, and colleagues found that no patient who went home on the same day as their total hip arthroplasty (THA) experienced a complication or readmission for medical reasons. Based on the results, the authors concluded that same-day discharge after THA is safe and that the goals are achieved in selected patients.

The authors also indicated that they believe same-day discharge will become more prevalent as its indications are clarified and as the practice gains acceptance.

The prospective pilot study included 55 of 144 eligible patients (38%) aged younger than 65 years who opted to enroll for same-day discharge after surgery. In all cases, surgeons performed uncemented, computer-assisted THA through a single posterior mini-incision. Also, all patients received a multi-modal analgesia protocol without narcotics, as published by Maheshwari et al., and underwent a rapid rehabilitation and recovery program, as published by Berger et al.

According to the study, reasons patients cited for choosing same-day discharge included: "30% because the surgeon offered it; 30% were more comfortable at home; 20% believed their recovery would be accelerated; and 20% did not like hospitals and wanted to avoid the hospital stay."

The study also included data on postoperative milestones gathered through patient diaries kept for 3 weeks after surgery and satisfaction questionnaires answered at 6 weeks follow-up.

Overall, 46 of the 55 enrolled patients went home on the same day as surgery, and 33 patients had 6-week follow-up data. Of these 33 patients, 32 indicated that they would opt for same-day discharge again.

Other results: pain scores at discharge averaged 1.24; pain score at 2 weeks averaged 2.21; 67% of patients who worked prior to the surgery returned to work within 2 weeks; 88% of the 33 with 6-week follow-up could walk 1 mile within 2 weeks; and 97% said they were glad they had the same-day-discharge surgery and would recommend it to others, according to the study.

For more information:
Thomas DJ, Chao BS Wan Z, et al. Early outcomes and safety of same-day total hip arthroplasty. Presented at the 120th Annual Meeting of the American Orthopaedic Association. June 15, 2007. Asheville, N.C.