Reducing incision length or intensifying rehabilitation: what makes the difference to length of stay in total hip replacement in a UK setting?
Minimal-incision surgery for hip arthroplasty and intensive post-op physiotherapy have both been shown to allow early mobilisation and to reduce hospital stay. Forty-five patients undergoing primary total hip arthroplasty using a standard posterior approach were compared with 51 patients using a minimal incision. In both groups, physiotherapy involved either a routine or intensive regime. Patients were matched in age, sex and body mass index. There was no significant difference in blood loss, post-operative stay and change in Oxford hip scores at one year between the mini- and standard-incision groups. There was a significant difference (P=0.003) in length of stay between routine- and intensive-physiotherapy groups (11.4 vs. 7.9 days). The dislocation rate was higher in the mini-incision group. This study suggests that in a standard UK setting, intensive physiotherapy can significantly decrease in-patient stay, but reducing the incision length does not.
Department of Orthopaedic Surgery, Chorley & South Ribble District General Hospital, Lancashire Teaching Hospitals, NHS Trust, Preston Road, Chorley, Lancashire, PR7 1PP, UK. docpecker@hotmail.com
C N
CN
Peck
A
A
Foster
G J
GJ
McLauchlan
D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D015207:Osteoarthritis, Hip / Q000534:rehabilitation* / Q000601:surgery; D026741:Physical Therapy Modalities; D016896:Treatment Outcome; D006113:United Kingdom