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· DOS Abstracts
Fast-track pathway for reduction of dislocated Hip
Arthroplasty reduces surgical delay and length of stay
Kirill Gromov, Fatin Willendrup , Henrik Palm, Anders Troelsen, Henrik Husted
Department of Orthopaedic Surgery, Copenhagen University Hospital
Hvidovre
Background:
Dislocation is one of the most common complications following
hip arthroplasty. Delay until reduction leads to pain and discomfort for the pa-
tient and can potentially increase risk for complications.
Purpose / Aim of Study:
In this study we investigated the safety aspect of a
fast-track pathway for dislocated hip arthroplasties and evaluated its effect on
surgical delay and Length of Stay (LOS)
Materials and Methods:
402 consecutive and unselected dislocations (253
patients) were admitted at our institution between 05-10-2010 and 09- 31-
2013. Fast track pathway for early reduction was introduced on 01.01.2012.
Fast track patients with clinically suspected dislocation (no radiographic verifica-
tion) were moved directly to post anesthesia care unit (PACU) and then straight
to the OR (operating room). Dislocation was confirmed under fluoroscopy and
reduced under general anesthesia. Surgical delay (hours), LOS (hours), periop-
erative complications and complications during hospital stay were recorded.
Dislocation status for fast-track patients (confirmed vs unconfirmed by fluo-
roscopy) was recorded as well
Findings / Results:
Both surgical delay (2.5 vs 4.1; p<0.001) and LOS (26.0
vs 30.5; p<0.05) were significantly reduced in patients admitted through fast-
track pathway compared to regular pathway. Perioperative complications (1.6%
vs 3.7%) and complications during stay (11.2% vs 15.4%) were also reduced,
however insignificantly. Only 1 case admitted through fast-track pathway had a
fracture instead of a dislocation; no fast-track patients with suspected disloca-
tion had no dislocations
Conclusions:
Fast-track pathway for reduction of dislocated hip arthroplasty
results in decreased surgical delay as well as LOS, without increasing periopera-
tive complications or complications during hospital stay
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