title: A multidisciplinary total hip arthroplasty protocol with accelerated postoperative rehabilitation: does the patient benefit?
abstract: Since its debut over 10 years ago, minimally invasive total hip arthroplasty (THA) has often been associated with accelerated postoperative rehabilitation when compared with THA performed with a traditional surgical approach. The objective of this study was to investigate the effect of accelerated postoperative rehabilitation and early mobilization on length of stay and hospital readmissions in patients undergoing THA at one institution. We retrospectively reviewed a consecutive series of 590 patients who underwent THA between January 31, 2011 and April 30, 2011. Six arthroplasty surgeons using varying surgical techniques participated. One hundred ninety patients received accelerated rehabilitation and were mobilized on the day of surgery. The remaining 400 patients were mobilized on postoperative day one (POD1). Length of stay for the accelerated rehabilitation group was 2.06 days and 3.38 days for the standard group. One patient was readmitted to the hospital within 30 days (.52%) in the accelerated group compared to 19 re-hospitalizations (4.72%) in the POD1 group. Ninety-six percent of the accelerated group were discharged home versus 62% in POD1 group. Our results support the use of an accelerated rehabilitation protocol at one institution following total hip replacement surgery.
authors.affiliation: Department of Orthopedics, New England Baptist Hospital, Boston, MA. crobbins@nebh.org.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Robbins
authors.forename: Daniel
authors.initials: D
authors.lastname: Casey
authors.forename: James V
authors.initials: JV
authors.lastname: Bono
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Murphy
authors.forename: Carl T
authors.initials: CT
authors.lastname: Talmo
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Ward
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery*; D026741:Physical Therapy Modalities; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult