Hip arthroplasty patients benefit from accelerated perioperative care and rehabilitation: a quasi-experimental study of 98 patients.

BACKGROUND AND PURPOSE: More than 6,500 hip arthroplasties were performed in Denmark in 2005. Accelerated perioperative interventions are currently implemented, and the length of stay is thereby reduced. An increase in postoperative health-related quality of- life (HRQOL) has been observed for hip patients after accelerated perioperative procedures compared to standard procedures. However, no studies have used HRQOL as a primary outcome. We therefore performed a before-after trial to investigate whether HRQOL would be improved postoperatively in hip arthroplasty patients undergoing accelerated perioperative care and rehabilitation intervention compared to those undergoing current intervention.

PATIENTS AND METHODS: 98 elective primary hip arthroplasty patients underwent either a standard procedure or an accelerated perioperative procedure (n = 48 and n = 50, respectively). Primary outcome was difference in HRQOL measured with EQ-5D, which measures HRQOL in 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) at the 3-month follow-up visit.

RESULTS: HRQOL was markedly improved in both groups. A significant difference in HRQOL at follow-up of 0.08 (95% CI: 0.01-0.15) in favor of the patients who received the accelerated intervention was observed (p = 0.02).

INTERPRETATION: Hip arthroplasty patients benefit postoperatively from accelerated perioperative care and rehabilitation procedures, with an HRQOL that is approximately 10% higher than that of patients receiving standard procedures.