Hip arthroplasty patients benefit from accelerated perioperative care and rehabilitation: A quasi-experimental study of 98 patients

Abstract

Background and purpose  More than 6,500 hip arthroplasties were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, and the length of stay is thereby reduced. An increase in postoperative health-related quality of- life (HRQOL) has been observed for hip patients after accelerated perioperative procedures compared to standard procedures. However, no studies have used HRQOL as a primary outcome. We therefore performed a before-after trial to investigate whether HRQOL would be improved postoperatively in hip arthroplasty patients undergoing accelerated perioperative care and rehabilitation intervention compared to those undergoing current intervention. Patients and methods  98 elective primary hip arthroplasty patients underwent either a standard procedure or an accelerated perioperative procedure (n = 48 and n = 50, respectively). Primary outcome was difference in HRQOL measured with EQ-5D, which measures HRQOL in 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) at the 3-month follow-up visit. Results  HRQOL was markedly improved in both groups. A significant difference in HRQOL at follow-up of 0.08 (95% CI: 0.01–0.15) in favor of the patients who received the accelerated intervention was observed (p = 0.02). Interpretation  Hip arthroplasty patients benefit postoperatively from accelerated perioperative care and rehabilitation procedures, with an HRQOL that is approximately 10% higher than that of patients receiving standard procedures.