title: Day-of-Surgery Mobilization Reduces the Length of Stay After Elective Hip Arthroplasty.
abstract: To determine the effect of mobilization on the day of surgery on the readiness for discharge and length of stay after elective total hip arthroplasty (THA).
  
  
  
  We devised a randomized control trial with concealed allocation and intention-to-treat analysis. Overall, 126 patients who underwent THA and met the criteria for mobilization on the day of surgery were randomly allocated into 2 groups; the intervention group was mobilized on the day of surgery, n = 58 and the control group was mobilized on the day after surgery, n = 68. Apart from timing of mobilization, both groups received the same postoperative management. The primary outcome measures were length of hospital stay and time to readiness for discharge.
  
  
  
  The early mobilization group was ready for discharge 63 hours (standard deviation [SD] = 15 hours) after surgery, compared to 70 hours (SD = 18 hours) for the control group (P = .03, 95% CI, 0.7-12.8). There was no significant difference in hospital stay in the early mobilization group (77 hours [SD = 30 hours]), compared to the control group (87 hours [SD = 35 hours]; P = .11, 95% CI, -2.1 to 21.6). Despite this at any point in time after the surgery, the intervention group was 1.8 times (P = .003, 95% CI, = 1.2-2.7) more likely to have been discharged.
  
  
  
  Mobilization on the day of THA surgery significantly increases the probability of discharge at any singular point in time compared with mobilization on the day after surgery and decreases the time to readiness for discharge.
authors.affiliation: Department of Orthopaedic Surgery, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: Taro
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Physiotherapy Department, Osborne Park Hospital, Stirling, WA, Australia.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Ridley
authors.affiliation: Department of Orthopaedic Surgery, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Edmondston
authors.affiliation: Physiotherapy Department, Osborne Park Hospital, Stirling, WA, Australia.
authors.forename: Mariet
authors.initials: M
authors.lastname: Visser
authors.affiliation: Department of Orthopaedic Surgery, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Headford
authors.affiliation: Department of Orthopaedic Surgery, Fremantle Hospital, Fremantle, WA, Australia.
authors.forename: Piers J
authors.initials: PJ
authors.lastname: Yates
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D004434:Early Ambulation; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D011184:Postoperative Period; D016016:Proportional Hazards Models
keywords: accelerated; enhanced recovery program; fast-track; hip; rehabilitation; replacement