Generally healthy patients who undergo total hip replacement (THR) can be fast tracked for discharge in two days, compared with the standard three to six days, according to a new study by researchers at Hospital for Special Surgery (HSS) in New York City. The study could help cut down on hospital-acquired infections, reduce hospital costs and improve patient satisfaction.
"Before this study, we were uncertain how safe it would be to discharge patients within two days after a total hip replacement, but based on this study, we now know that it is safe. This is evidenced by the fact that the patients who were discharged within two days did not have an increase in complications, readmissions or re-operations," said Lawrence Gulotta, M.D., an orthopedic surgeon at HSS and first author of the study. "This is something that can help improve healthcare costs and provide better care for our patients by keeping them out of the hospital," stated Bryan Nestor, M.D., an orthopedic surgeon in Adult Reconstruction and Joint Replacement Service at HSS, and principal investigator of the study.
"For a select group of patients, we have shown that a two-day discharge is safe and feasible for patients undergoing a total hip replacement," Dr. Nestor said. He pointed out that the two-day fast track is not for higher-risk patients. While the authors did not measure if the fast track protocol saves money, since it involves shortened hospital stays, the researchers expect it to.
Roughly half a million THRs are conducted every year in the United States, and this number is expected to grow. Many in the baby boomer generation are not willing to be sedentary and as their joints age, they are demanding joint replacement surgeries to keep active.
Other HSS authors involved in the study are Douglas Padgett, M.D., Thomas Sculco, M.D., Michael Urban, M.D., Ph.D., and Stephen Lyman, Ph.D. No author received financial support related to the study.