@article{Lindberg-Larsen_Petersen_Corap_Gromov_Jørgensen_Kehlet_the Centre for Fast-track Hip and Knee Replacement Collaborating Group_2022, title={Fast-track revision hip arthroplasty: a multicenter cohort study on 1,345 elective aseptic major component revision hip arthroplasties}, volume={93}, url={https://actaorthop.org/actao/article/view/2196}, DOI={10.2340/17453674.2022.2196}, abstractNote={<p><strong>Background and purpose:</strong> Data on application of fasttrack/enhanced recovery protocols in revision hip arthroplasty (R-THA) surgery is scarce. We report length of stay (LOS), risk of LOS > 5 days, and readmission ≤ 90 days after revision hip arthroplasty in centers with a well-established fast-track protocol in both primary and revision procedures.</p> <p><strong>Patients and methods:</strong> This is an observational cohort study from the Centre for Fast-track Hip and Knee Replacement and the Danish Hip Arthroplasty Register. Consecutive elective aseptic major component revision hip arthroplasties from 6 dedicated fast-track centers from 2010 to 2018 were included.</p> <p><strong>Results:</strong> 1,345 R-THAs were analyzed, including 23% total revisions, 52% acetabular component revisions, and 25% femoral component revisions. Mean age was 70 years (SD 12) and 61% were female. Median LOS was 3 days (interquartile range [IQR] 2–6), decreasing from median 6 (IQR 3–10) days in 2010 to 2 (IQR 1–4) days in 2018. The 90-day readmission rate was 20%, but showed a fluctuating and increasing trend from 13% in 2010 to 28% in 2018. Risk factors for LOS > 5 days and readmission were use of walking aid, preoperative hemoglobin ≤ 13 g/dL, pharmacological treated psychiatric disorder, age ≥ 80 years, age 70–79 years (only LOS > 5 days), cardiac disease (only LOS > 5 days), pulmonary disease (only readmission), BMI ≥ 35 (only LOS > 5 days) and ≥ 1 previous revision (only LOS > 5 days).</p> <p><strong>Interpretation:</strong> LOS decreased to median 2 days at the end of the study period, but the 90 days readmission risk remained high (> 20%). Several risk factors for postoperative complications were identified, suggesting that at-risk patients should be treated using an extended fast-track/enhanced recovery protocol focusing on preoperative optimization and postoperative monitoring as well as surgical techniques to reduce hip dislocations.</p>}, journal={Acta Orthopaedica}, author={Lindberg-Larsen, Martin and Petersen, Pelle Baggesgaard and Corap, Yasemin and Gromov, Kirill and Jørgensen, Christoffer Calov and Kehlet, Henrik and the Centre for Fast-track Hip and Knee Replacement Collaborating Group, on behalf of}, year={2022}, month={Feb.}, pages={341–347} }