Total hip arthroplasty is one of the most successful surgical operations in medicine, allowing the patient to return to a more normal life and to most physical activities, free of pain. The overwhelming majority of patients report great satisfaction with a result that lasts for many years after the operation.
Traditionally this operation, being a major one, meant a hospital stay of many days for the patient, a slow and gradual start to mobilisation, the need for prolonged nursing support and a slow, gradual return to everyday activities.
Today, fast-track protocols are applied in the overwhelming majority of patients, with which the patient becomes immediately independent in movement, since they can stand (bearing full weight on the leg) on the same day as the operation, walk the next day and go up and down stairs the day after that. Once past the stairs the patient is considered independent in movement.
Fast-track protocols came into use because of the newer materials now used, the new surgical approaches of lower invasiveness (less traumatic, with less blood loss), the use of high-precision robotic systems, respect for the muscle groups of the area, and also the cooperation between surgeon – nursing – physiotherapy staff, whose coordination accelerates rehabilitation.
In this way the patient’s usual stay in the clinic is 1 to 2 days (overnight stays), particularly for those without serious underlying conditions. In only a few cases is a stay in a rehabilitation centre needed, mainly in patients with an inadequate family and social environment.
Fast-track protocols have made it possible for young, working patients to continue their professional, social and family life without interruption, with only a short pause.
Sources:
Petersen, P.B., Kehlet, H., Jørgensen, C.C. et al. Improvement in fast-track hip and knee arthroplasty: a prospective multicentre study of 36,935 procedures from 2010 to 2017. Sci Rep 10, 21233 (2020).
Jung KD, Husted H, Kristensen BB. Knie- und Hüfttotalendoprothese in 2 Tagen : Das dänische Fast-Track-Modell [Total knee and hip arthroplasty within 2 days : The Danish Fast-Track Model]. Orthopade. 2020 Mar;49(3):218-225. German.
Clarius M, Nöth U. Fast-Track-Endoprothetik [Fast-track hip and knee arthroplasty]. Orthopade. 2020 Apr;49(4):289.