title: Role of preoperative pain, muscle function, and activity level in discharge readiness after fast-track hip and knee arthroplasty.
abstract: OBJECTIVE
  The concept of fast-track surgery has led to a decline in length of stay after total hip arthroplasty (THA) and total knee arthroplasty (TKA) to about 2-4 days. However, it has been questioned whether this is only achievable in selected patients-or in all patients. We therefore investigated the role of preoperative pain and functional characteristics in discharge readiness and actual LOS in fast-track THA and TKA.
  
  
  METHODS
  Before surgery, hip pain (THA) or knee pain (TKA), lower-extremity muscle power, functional performance, and physical activity were assessed in a sample of 153 [corrected] patients and used as independent variables to predict the outcome (dependent variable) – readiness for hospital discharge – for each type of surgery. Discharge readiness was assessed twice daily by blinded assessors
  
  
  RESULTS
  Median discharge readiness and actual length of stay until discharge were both 2 days. Univariate linear regression followed by multiple linear regression revealed that age was the only independent predictor of discharge readiness in THA and TKA, but the standardized coefficients were small (≤ 0.03).
  
  
  CONCLUSIONS
  These results support the idea that fast-track THA and TKA with a length of stay of about 2-4 days can be achieved for most patients independently of preoperative functional characteristics.
authors: The Lundbeck Center for Fast-track Hip- and Knee Arthroplasty.
authors: Bente
authors: B
authors: Holm
authors: Thomas
authors: T
authors: Bandholm
authors: Troels Haxholdt
authors: TH
authors: Lunn
authors: Henrik
authors: H
authors: Husted
authors: Peter Kloster
authors: PK
authors: Aalund
authors: Torben Bæk
authors: TB
authors: Hansen
authors: Henrik
authors: H
authors: Kehlet
mesh_terms: D000367:Age Factors; D000368:Aged; D018771:Arthralgia / Q000453:epidemiology*; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010147:Pain Measurement; D010351:Patient Discharge / Q000706:statistics & numerical data*; D057234:Preoperative Period