title: Feasibility of day-case total hip arthroplasty: a single-centre observational study.
abstract: BACKGROUND
  Recent reports indicate that total hip arthroplasty (THA) can be further accelerated and might be managed as day-case. This could provide benefits to health care expenditure, lower patient risks and change patient satisfaction. We evaluated the feasibility, efficacy, safety and patient satisfaction of same-day (<12 hours) THA operation and discharge.
  
  
  METHODS
  Consecutive patients were screened for eligibility (primary THA, ASA 1 or 2 physical status) and the presence of a support person to follow the patient for 48 hours postoperatively in an observational study. THA was managed as day-case (<12 hours) through patient selection, preoperative patient education programme, light spinal anaesthesia, low opioid usage, and early mobilisation. Efficacy and logistics were analysed and compared to current accelerated practice. Patient satisfaction was compared to existing fast-track THA and elective surgery cohorts.
  
  
  RESULTS
  29 consecutive patients were screened and 20 participated (69%). 17/20 patients (85%) were released on the day of surgery. There were no serious adverse events or complications, and no infections or readmission at 6-week follow-up. Patient overall satisfaction rating (1-5) was high (4.75), higher than in a 301-patient cohort (4.53) (THA and total knee arthroplasty) from the same centre (p = 0.23), and higher than in a national, elective surgery cohort (4.3) (p = 0.04).
  
  
  CONCLUSIONS
  We report the feasibility of day-case THA. Safety, complications and overall patient acceptance were satisfactory. Light spinal anaesthesia facilitated quick transit through postanaesthesia care unit to early mobilisation. Support persons and patient education may play a part in high patient acceptance of day-case surgery.
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.| Institute for Clinical Medicine, Aarhus University Hospital, Aarhus - Denmark.
authors: Jens Rolighed
authors: JR
authors: Larsen
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Birgitte
authors: B
authors: Skovgaard
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Thomas
authors: T
authors: Prynø
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Laimonas
authors: L
authors: Bendikas
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Lone R
authors: LR
authors: Mikkelsen
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Malene
authors: M
authors: Laursen
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Mette T
authors: MT
authors: Høybye
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Søren
authors: S
authors: Mikkelsen
authors:  Centre for Elective Surgery, Silkeborg Regional Hospital, Silkeborg - Denmark.
authors: Lene Bastrup
authors: LB
authors: Jørgensen
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods; D003718:Denmark; D017558:Elective Surgical Procedures / Q000379:methods; D005240:Feasibility Studies; D005500:Follow-Up Studies; D007902:Length of Stay; D008991:Monitoring, Physiologic; D010351:Patient Discharge; D061214:Patient Safety; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D018579:Patient Selection; D011446:Prospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome