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Most patients in ‘short stay’ THA program remained satisfied at latest follow-up
Patients attended "joint training school" before admission to the hospital. They learned to use crutches and practiced using them at home prior to THA surgery.
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Researchers from the United Kingdom have reported from their study of 100 consecutive patients the positive results after implementing a “short stay” hip program, which educates patients and then discharges them within about 2 days of uncemented total hip arthroplasty procedures.
“Short length of stay is very achievable in the district general hospital setting,” Sebastian Dawson-Bowling, FCRS(Tr&Orth), said in his presentation at the British Orthopaedic Association Congress. “These are highly reproducible steps and we believe the program can be reproduced elsewhere,” he said.
Of 100 patients in the program evaluated at the 3-year to 5-year follow-up, there was one dislocation, one myocardial infarction and one deep infection. Patients were 65 years old, mean, with a mean American Society of Anaesthesiologists (ASA) score of 1.97. They stayed in the hospital for a mean of 1.99 nights. There was no association between ASA score and age, according to the abstract.
Patients underwent a half-day “joint school training” regime prior to admission for total hip arthroplasty (THA), where they were assessed in a group session, followed by individual physiotherapy and nursing assessments, Dawson-Bowling said. Prior to surgery, the patients received crutches for practice at home.
Surgeons performed THA with uncemented implants through a mini-posterior approach using low dose spinal and general anesthesia in all the patients, which provided excellent pain relief without loss of motor function. Postoperatively, the patients all had access to outreach care, he said.
According to Dawson-Bowling, the ASA score and mean patient age were broadly comparable to the national averages.
The study results presented in the abstract showed that of 82 patients under current follow-up, 97% remained satisfied or highly satisfied with their implants. – by Jeff Craven
- Reference:
- Dawson-Bowling S. Paper #30. Presented at: British Orthopaedic Association Congress; Sept. 11-14, 2012; Manchester.
- For more information:
- Sebastian Dawson-Bowling, FRCS(Tr&Orth), can be reached at Orthopaedic Department, Conquest Hospital, The Ridge, St. Leonards-on-Sea, East Sussex, United Kingdom; email: sebd_b@hotmail.com.
Disclosure: Dawson-Bowling has no relevant financial disclosures.