Z Orthop Unfall
DOI: 10.1055/a-0946-2523
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Outcome of an “Enhanced Recovery” Program in Contemporary Total Hip Arthroplasty in Germany

Article in several languages: English | deutsch
Karl Philipp Kutzner
1  Klinik für Orthopädie und Unfallchirurgie, St. Josefs Hospital Wiesbaden
2  Zentrum für Orthopädie und Unfallchirurgie (ZOU), Universitätsmedizin Mainz
,
Alexander Meyer
1  Klinik für Orthopädie und Unfallchirurgie, St. Josefs Hospital Wiesbaden
,
Marie Bausch
1  Klinik für Orthopädie und Unfallchirurgie, St. Josefs Hospital Wiesbaden
,
Michael Schneider
1  Klinik für Orthopädie und Unfallchirurgie, St. Josefs Hospital Wiesbaden
,
Philipp Rehbein
1  Klinik für Orthopädie und Unfallchirurgie, St. Josefs Hospital Wiesbaden
,
Philipp Drees
2  Zentrum für Orthopädie und Unfallchirurgie (ZOU), Universitätsmedizin Mainz
,
Joachim Pfeil
1  Klinik für Orthopädie und Unfallchirurgie, St. Josefs Hospital Wiesbaden
› Author Affiliations
Further Information

Publication History

Publication Date:
16 September 2019 (online)

Abstract

Background An inpatient hospital stay of up to 10 days after total hip arthroplasty (THA) is still common in Germany, mostly followed by inpatient rehabilitation. Internationally already widespread concepts for enhanced recovery are increasingly gaining popularity in Germany.

Objectives The presentation of content and results of a newly implemented enhanced recovery concept in THA.

Materials and Methods In this single-center, prospective observational study of a consecutive patient collective of a single surgeon, between January 2016 and July 2016, 103 short-stem THA patients were enrolled and treated using a newly introduced enhanced recovery concept. After 6 weeks and 6 months clinical examination was performed regarding function, pain, satisfaction and possible complications.

Results The goal of discharge on day 4 after operation was reached in 61.2% of the patients with a mean postoperative inpatient stay of 4.9 days. After 6 weeks and 6 months respectively, excellent clinical results were achieved with high patient satisfaction. The complication rate was found to be low. Mean hemoglobin concentration decreased by 2.1 g/dl. A fissure of the femur below the implant healed conservatively applying no weight bearing for a total of 6 weeks. A pulmonary embolism that occurred during rehabilitation was also successfully treated. After 6 months one case showed a bursitis trochanterica.

Conclusions Inpatient length of stay can be reduced by enhanced recovery concepts without increasing the risks to patients. Thus, in Germany these concepts will be applied increasingly.