The first 6 weeks of recovery after primary total hip arthroplasty with fast track

Abstract

Background and purpose - Fast-track protocols have been introduced worldwide to improve the recovery after total hip arthroplasty (THA). These protocols have reduced the length of hospital stay (LOS), and THA in an outpatient setting is also feasible. However, less is known regarding the first weeks after THA with fast track. We examined patients' experiences of the first 6 weeks after hospital discharge following inpatient and outpatient THA with fast track. Patients and methods - In a prospective cohort study, 100 consecutive patients who underwent THA surgery in a fast-track setting between February 2015 and October 2015 received a diary for 6 weeks. This diary contained various internationally validated questionnaires including HOOS-PS, OHS, EQ-5D, SF-12, and ICOAP. In addition, there were general questions regarding pain, the wound, physiotherapy, and thrombosis prophylaxis injections. Results - 94 patients completed the diary, 42 of whom were operated in an outpatient setting. Pain and use of pain medication had gradually decreased during the 6 weeks. Function and quality of life gradually improved. After 6 weeks, 91% of all patients reported better functioning and less pain than preoperatively. Interpretation - Fast track improves early functional outcome, and the PROMs reported during the first 6 weeks in this study showed continued improvement. They can be used as a baseline for future studies. The PROMs reported could also serve as a guide for staff and patients alike to modify expectations and therefore possibly improve patient satisfaction.

Figure 1.

Daily mean NRS pain score preoperatively to day 42 after discharge. Error bars show 95% CI.