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Pre-operative education prior to elective hip arthroplasty surgery improves postoperative outcome

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Abstract

Purpose

Enhanced recovery programmes have improved outcomes following elective arthroplasty surgery. There are few studies assessing the role of patient education. We therefore assessed the outcomes for patients treated at our unit.

Methods

In our enhanced recovery programme, all patients are offered the chance to attend a pre-operative education class. Not all patients attend, thus allowing comparison of outcomes using our prospectively collected database.

Results

Between April 2009 and March 2013, 318 patients underwent elective total hip replacement (THR): 233 attended the class, and 85 did not. Patients attending had a significantly reduced length of stay when compared with nonattenders (3.53 vs 4.27 days, p = 0.046). This produced cost savings of >£10,000 per year.

Conclusion

Our analysis demonstrates that preoperative education produces significantly shorter lengths of stay and cost savings. There are also effects on mobilisation and outcome scores. Patients should therefore be encouraged to attend these classes.

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References

  1. McDonald DA, Siegmeth R, Deakin AH, Kinnimonth AW, Scot NB (2012) An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom—follow up at 1 year. Knee 19(5):525–529

    Article  CAS  PubMed  Google Scholar 

  2. den Hertog A, Gliesche K, Timm J, Muhlbauer B, Zebrowski S (2012) Pathway-controlled fast-track rehabilitation after total knee arthroplasty: a randomized prospective clinical study evaluating recovery pattern, drug consumption and length of stay. Arch Orthop Trauma Surg 132(8):1153–1163

    Article  Google Scholar 

  3. Mertes SC, Raut S, Khanduja V (2013) Integrated care pathways in lower limb arthroplasty: are they effective in reducing length of hospital stay? Int Orthop 37(6):1157–1163

    Article  PubMed Central  PubMed  Google Scholar 

  4. Larsen K, Hansen TB, Thomsen PB, Christiansen T, Soballe K (2009) Cost-effectiveness of accelerated perioperative care and rehabilitation after total hip and knee arthroplasty. J Bone Joint Surg Am 91(4):761–772

    Article  PubMed  Google Scholar 

  5. Livsley PJ, Rider MA (1993) Joint replacement and patient education. Int Orthop 17(1):34–36

    Google Scholar 

  6. McDonald S, Hetrick SE, Green S (2004) Pre-operative education for hip or knee replacement. Cochrane Database Syst Rev, Issue 1. Art. No.: CD003526. doi: 10.1002/14651858.CD003526.pub2

  7. Jones S, Alnaib M, Kokkinakis M, Wilkinson M, Gibson ASC, Kader D (2011) Preoperative education reduces length of stay after knee joint arthroplasty. Ann R Coll Surg Engl 93:71–75. doi:10.1308/003588410X12771863936765

    Article  PubMed Central  PubMed  Google Scholar 

  8. Yoon RS, Nellans KW, Geller JA, Kim AD, Jacobs MR, Macaulay W (2010) Patient education before hip or knee arthroplasty lowers length of stay. J Arthroplasty 25:547–551

    Article  PubMed  Google Scholar 

  9. Huang SW, Chen PH, Chou YH (2012) Effects of a preoperative simplified home rehabilitation programme on length of stay of total knee arthroplasty patients. Orthop Trauma Surg Res 98:259–264

    Article  Google Scholar 

  10. Louw A, Diener I, Butler DS, Puentedura EJ Preoperative education addressing postoperative pain in total joint arthroplasty: review of contend and educational delivery methods. Physio Theory Prac Online ahead of print

  11. Giraudet-Le Quintrec JS, Coste J, Vastel L, Pacault V, Jeanne L, Lamas JP, Kerboull L, Fougeray M, Consellier C, Kahan A, Courpied JP (2003) Positive effect of patient education for hip surgery: a randomised controlled trial. Clin Orthop Relat Res 414:112–120

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank all arthroplasty surgeons at the Wrexham Maelor Hospital for allowing us to include their patients in this study: Mr. Philips, Mr. Wooton, Mr. Wilson, Mr. Whittaker. We also thank Gill Royce and Sarah Lawrence for administering and maintaining the database.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Trauma and Orthopaedics, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham, LL13 7TD, UK

    Lawrence S. Moulton, Peter A. Evans, Ian Starks & Tony Smith

  2. ST6 Trauma and Orthopaedics, University Hospital of North Midlands, Newcastle Road, Stoke-on-Trent, Staffordshire, ST4 6QG, UK

    Lawrence S. Moulton

Authors
  1. Lawrence S. Moulton
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  2. Peter A. Evans
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  3. Ian Starks
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  4. Tony Smith
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Corresponding author

Correspondence to Lawrence S. Moulton.

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Moulton, L.S., Evans, P.A., Starks, I. et al. Pre-operative education prior to elective hip arthroplasty surgery improves postoperative outcome. International Orthopaedics (SICOT) 39, 1483–1486 (2015). https://doi.org/10.1007/s00264-015-2754-2

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  • DOI: https://doi.org/10.1007/s00264-015-2754-2

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