BARCELONA, Spain — Outpatient total hip arthroplasty was successful and was not associated with serious adverse events in 95% of patients, according to Erwan Pansard, MD, who said consent to outpatient THA by the patient and his or her family was essential to these results.
At the EFORT Annual Congress, here, Pansard said he and his colleagues in France hypothesized that outpatient THA would be safe and feasible to perform. The cases he discussed all involved patients who underwent surgery at either a public or private hospital in France early in the day, between 8:30 a.m. and 1:00 p.m., and were discharged to home at about 7:00 p.m. In the prospective observational study, two senior surgeons performed the procedures using a direct anterior approach in 231 patients who were American Association of Anesthesiologists grade 3 or 4.
The primary study outcome was whether cases performed in the outpatient surgery setting required a hospitalization or re-hospitalization of a patient in the first postoperative week. The secondary outcomes were complication rates at 1 month postoperatively and whether the patient and spouse were satisfied with the surgical result at the 6-month follow-up visit.
According to Pansard, none of the patients who ultimately underwent outpatient THA were rehospitalized within 1 week of surgery.
“The rate of outpatient surgery success was 95.5%,” he said.
At the 1-month postoperative follow-up, researchers observed three adverse events, which including two dislocations and one periprosthetic fracture, which occurred after a fall.
“At the 6-week follow-up, 312 (97.2%) patients were satisfied,” researchers wrote in the study abstract.
“This also included their spouses,” Pansard noted.
“The mental preparation of the patient is essential,” according to Pansard.
Patients were prepared for their upcoming procedures by participating in a group information session about the surgery and its expectations in the presence of their spouses and the surgeon. In addition, on the day of surgery, a special surgical and anesthesia checklist was used and validated prior to start of THA surgery.
“To be successful, both patients and their spouses must consent to postoperative management of THA,” Pansard said.
A study limitation was that the patients were highly selected for these procedures to be assisted by their spouses and they were operated on by senior surgeons, he said. – by Susan M. Rapp
Pansard E, et al. Paper 1115. Presented at: EFORT Annual Congress; May 30-June 1, 2018; Barcelona, Spain.
Disclosure: Pansard reports no relevant financial disclosures.