Journal of Clinical & Experimental Orthopaedics

New hip in a day - Setup and clinical experiences of outpatient hip replacement surgery in Germany

Joint Event on 11^th International Conference on Osteoporosis, Arthritis & Musculoskeletal Disorders & 10^th International Conference on Arthroplasty
December 04-05, 2017 | Madrid, Spain

Ilan Elias, Manfred Krieger and Thilo Hartmann

GPR Hospital R�¼sselsheim, Germany

Posters & Accepted Abstracts: J Clin Exp Orthop

DOI: 10.4172/2471-8416-C1-003

Abstract

Outpatient total hip replacement (THR) procedures are increasing in the orthopedic surgery community, especially in the USA, Scandinavia, and in Benelux countries. To the best of our knowledge, our study group is the first to report setup and first clinical experiences of ambulatory THR in Germany. From June 2016 until August 2017 41 patients (22 female/19 male, average age 60 years) underwent ambulatory primary hip replacement surgery in our institution with a direct anterior approach and all under general anesthesia. All patients were carefully selected and enrolled in our so called "Hip-in-a-Day" program. We have developed a protocol to identify which patients are suitable for this program and which ones should not undergo short stay hip arthroplasty. In addition, we have set up a strict immediate post-op regimen, which consist of eating, sleeping, and exercising, as well as defined discharge criteria. To optimize the pre-operative preparations, we implemented a so-called Rapid-Recovery-School for our patients. This includes a patient teaching and training course by each of the involved professional groups (surgeon, anesthesiologist, nurse, physical therapist, social worker, etc.) one week prior to surgery. By changing and optimizing the anesthesiologic setup, using minimally invasive surgical techniques, improving intra- and post-operative pain therapy, as well as optimizing physical therapy, we have now been able to perform single-day outpatient hip replacement procedures in selected patients for over one year. There were no readmissions, complications due to too early discharge or any other adverse events related to shortened length of stay. All patients that were initially identified for the ambulatory pathway, were in fact discharged the same day of surgery. There were no clinical reasons for prolonged length of stay. During the follow-up course all patients stated that they were very satisfied with the ambulatory concept and that they would recommend it to a friend or family member.