24 hours stay after hip replacement

Figures & data

Table 1. Patient characteristics

	All	Male	Female
Sex distribution	n = 378	33%	67%
Mean age (range)	65 (27–85)	63 (27–85)	66 (38–83)
Mean BMI (range)	25 (18–37)	26 (18–35)	24 (18–37)
ASA score I	49%	48%	49%
II	49%	51%	49%
III	2%	1%	2%
Proportion with primary OA	97%	99%	96%

Table 2. Elements of the time-based fast-track protocol

Written and oral information on a LOS of 24 hours by the surgeon

Preoperative education and information by the surgeon

Standardized general anesthesia combined with local infiltration

Standardized pain medication protocol (pre-, peri-, and postoperatively)

Standardized operation technique with traction table

Opioid medication only upon request during recovery and at home

No drains

No urinary catheters

Start mobilization 3 hours postoperatively

Anti-thrombotic prophylaxis over 10 days (Fraxiparine (nadroparin), 0 4 mL =3,800 IE)

Time-based discharge 1 day postoperatively after fulfilling discharge criteria

Mobilization without restrictions and no physiotherapy protocol for the first 14 days

Stimulation to be active with or without crutches

Telephone control by the surgeon 3 days postoperatively

Table 3. Process parameters

	All	Male	Female
	n = 378	n = 126	n = 252
Duration of surgery, min^a	59 (35–135)	65 (42–135)	56 (35–105)
Blood loss, mL^a	329 (100–1,200)	385 (100–1,200)	301 (100–850)
VAS pain score,^a
intake	6.5 (2–9)	5.8 (2–9)	6.8 (3–9)
discharge	2.4 (0–7)	2.3 (0–6)	2.5 (0–7)
LOS, hours^a	25.6 (23–28)	25.2 (23–27)	25.7 (23–28)
90-day re-admission, n (%)	8 (2)	5 (4)	3 (1)
90-day reoperation, n (%)	6 (2)	3 (2)	3 (1)
Rescue drug, n (%)	34 (9)	7 (6)	27 (11)
Physiotherapy postop., n (%)	160 (42)	47 (37)	113 (45)
Patient satisfaction	9.7	9.8	9.7

a mean (range)

Table 4. Complications within 90 days of primary THA in 23 of the 378 patients

	n
Lateral femoral cutaneous nerve injury (of which temporary)	7 (6)
Wound hematoma	5
Dislocation	2
Superficial infection	2
Subsidence	1
Deep infection	1
Femoral fracture	1
Femoral perforation	1
Calcar fissure	1
Inlay loosening	1
DVT	1
Total	23 (6%)