Successful initial experience with a novel outpatient total hip arthroplasty program in a public health system in Chile

Original Paper
  • 29 Downloads

Abstract

Purpose

The aim of the present study was to assess the first experience with outpatient total hip arthroplasty (THA) in a public health environment in Chile.

Methods

Prospective series of the first 69 patients/72 hips. Surgery was performed in a public university-affiliated hospital. The patients were 64 (31–84) years old and healthy (ASA I–II) candidates for a primary hip arthroplasty.

Results

The outpatient track had 52.2% of arthroplasty candidates included and 94.4% (68/72 hips) were successfully discharged the same day. There were no emergency room visits during the first week after surgery. Two patients had single dislocation episodes, one requiring stem revision. There was one deep vein thrombosis. There were no other complications. All the patients reported to be satisfied with the outpatient track.

Interpretation

An outpatient track can be developed in a safe manner in this healthcare setting and population. This track of care was well accepted by the patients.

Keywords

Total hip arthroplasty Length of stay Outpatient surgery Osteoarthritis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Coventry MB, Beckenbaugh RD, Nolan DR, Ilstrup DM (1974) 2,012 total hip arthroplasties. A study of postoperative course and early complications. J Bone Joint Surg Am 56(2):273–284CrossRefPubMedGoogle Scholar
  2. 2.
    Forrest GP, Roque JM, Dawodu ST (1999) Decreasing length of stay after total joint arthroplasty: effect on referrals to rehabilitation units. Arch Phys Med Rehabil 80(2):192–194CrossRefPubMedGoogle Scholar
  3. 3.
    Husted H, Holm G, Jacobsen S (2008) Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients. Acta Orthop 79(2):168–173.  https://doi.org/10.1080/17453670710014941 CrossRefPubMedGoogle Scholar
  4. 4.
    Husted H, Lunn TH, Troelsen A, Gaarn-Larsen L, Kristensen BB, Kehlet H (2011) Why still in hospital after fast-track hip and knee arthroplasty? Acta Orthop 82(6):679–684.  https://doi.org/10.3109/17453674.2011.636682 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Malviya A, Martin K, Harper I, Muller SD, Emmerson KP, Partington PF, Reed MR (2011) Enhanced recovery program for hip and knee replacement reduces death rate. Acta Orthop 82(5):577–581.  https://doi.org/10.3109/17453674.2011.618911 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Raphael M, Jaeger M, van Vlymen J (2011) Easily adoptable total joint arthroplasty program allows discharge home in two days. Can J Anaesth 58(10):902–910.  https://doi.org/10.1007/s12630-011-9565-8 CrossRefPubMedGoogle Scholar
  7. 7.
    Aynardi M, Post Z, Ong A, Orozco F, Sukin DC (2014) Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study. HSS J 10(3):252–255.  https://doi.org/10.1007/s11420-014-9401-0 CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Bertin KC (2005) Minimally invasive outpatient total hip arthroplasty: a financial analysis. Clin Orthop Relat Res 435:154–163CrossRefGoogle Scholar
  9. 9.
    Berry DJ, Berger RA, Callaghan JJ, Dorr LD, Duwelius PJ, Hartzband MA, Lieberman JR, Mears DC (2003) Minimally invasive total hip arthroplasty. Development, early results, and a critical analysis. Presented at the Annual Meeting of the American Orthopaedic Association, Charleston, South Carolina, USA, June 14, 2003. J Bone Joint Surg Am 85-A(11):2235–2246CrossRefPubMedGoogle Scholar
  10. 10.
    Dorr LD, Thomas DJ, Zhu J, Dastane M, Chao L, Long WT (2010) Outpatient total hip arthroplasty. J Arthroplast 25(4):501–506.  https://doi.org/10.1016/j.arth.2009.06.005 CrossRefGoogle Scholar
  11. 11.
    Courtney PM, Boniello AJ, Berger RA (2016) Complications following outpatient total joint arthroplasty: an analysis of a national database. J Arthroplast.  https://doi.org/10.1016/j.arth.2016.11.055
  12. 12.
    Jans O, Bundgaard-Nielsen M, Solgaard S, Johansson PI, Kehlet H (2012) Orthostatic intolerance during early mobilization after fast-track hip arthroplasty. Br J Anaesth 108(3):436–443.  https://doi.org/10.1093/bja/aer403 CrossRefPubMedGoogle Scholar
  13. 13.
    Husby VS, Helgerud J, Bjorgen S, Husby OS, Benum P, Hoff J (2009) Early maximal strength training is an efficient treatment for patients operated with total hip arthroplasty. Arch Phys Med Rehabil 90(10):1658–1667.  https://doi.org/10.1016/j.apmr.2009.04.018 CrossRefPubMedGoogle Scholar
  14. 14.
    Hartog YM, Mathijssen NM, Vehmeijer SB (2015) Total hip arthroplasty in an outpatient setting in 27 selected patients. Acta Orthop 1–4.  https://doi.org/10.3109/17453674.2015.1066211
  15. 15.
    Goyal N, Chen AF, Padgett SE, Tan TL, Kheir MM, Hopper RH Jr, Hamilton WG, Hozack WJ (2016) Otto Aufranc Award: a multicenter, randomized study of outpatient versus inpatient total hip arthroplasty. Clin Orthop Relat Res.  https://doi.org/10.1007/s11999-016-4915-z
  16. 16.
    Berger RA (2007) A comprehensive approach to outpatient total hip arthroplasty. Am J Orthop 36(9 Suppl):4–5PubMedGoogle Scholar
  17. 17.
    Eneqvist T, Nemes S, Bulow E, Mohaddes M, Rolfson O (2018) Can patient-reported outcomes predict re-operations after total hip replacement? Int Orthop 42(2):273–279.  https://doi.org/10.1007/s00264-017-3711-z CrossRefPubMedGoogle Scholar
  18. 18.
    Gromov K, Kjaersgaard-Andersen P, Revald P, Kehlet H, Husted H (2017) Feasibility of outpatient total hip and knee arthroplasty in unselected patients. Acta Orthop 1–7.  https://doi.org/10.1080/17453674.2017.1314158
  19. 19.
    Hunt GR, Crealey G, Murthy BV, Hall GM, Constantine P, O'Brien S, Dennison J, Keane P, Beverland D, Lynch MC, Salmon P (2009) The consequences of early discharge after hip arthroplasty for patient outcomes and health care costs: comparison of three centres with differing durations of stay. Clin Rehabil 23(12):1067–1077.  https://doi.org/10.1177/0269215509339000 CrossRefPubMedGoogle Scholar
  20. 20.
    Mauerhan DR, Lonergan RP, Mokris JG, Kiebzak GM (2003) Relationship between length of stay and dislocation rate after total hip arthroplasty. J Arthroplast 18(8):963–967CrossRefGoogle Scholar
  21. 21.
    Assi C, El-Najjar E, Samaha C, Yammine K (2017) Outcomes of dual mobility cups in a young Middle Eastern population and its influence on life style. Int Orthop 41(3):619–624.  https://doi.org/10.1007/s00264-016-3390-1 CrossRefPubMedGoogle Scholar
  22. 22.
    Ferreira A, Prudhon JL, Verdier R, Puch JM, Descamps L, Dehri G, Remi M, Caton JH (2017) Contemporary dual-mobility cup regional and private register: methodology and results. Int Orthop 41(3):439–445.  https://doi.org/10.1007/s00264-017-3405-6 CrossRefPubMedGoogle Scholar

Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Orthopedic SurgeryHospital Clinico Metropolitano de La FloridaSantiagoChile
  2. 2.MEDS Clinical Sport CenterSantiagoChile
  3. 3.Service of Physical TherapyHospital Clínico La FloridaSantiagoChile
  4. 4.Department of Physical Therapy, Faculty of MedicineUniversity of ChileSantiagoChile
  5. 5.Department of Orthopedic SurgeryPontificia Universidad Catolica de ChileSantiagoChile

Personalised recommendations