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General Orthopaedics

DOES THE OPERATIVE APPROACH USED IN TOTAL HIP REPLACEMENT SURGERY INFLUENCE PATIENT DISCHARGE TIMING?

Australian Orthopaedic Association and New Zealand Orthopaedic Association (AOA/NZOA) - Combined Annual Scientific Meeting



Abstract

Total hip replacement can be performed successfully via a number of approaches. A patient's time to discharge following a THR is influenced by many factors. The anterior hip approach has recently been popularised as a true muscle sparing approach. This study looked at the association between operative approach (anterior, lateral or posterior), and length of hospital stay.

A retrospective review was conducted at Western Health, Victoria of 113 consecutive THRs performed at 3 hospitals (Footscray, Sunshine and Williamstown) by 16 surgeons over a 12 month period. The data was collected from the prospective information entered into the digital database ‘Sunray’ and a review of the postoperative notes in order to perform a retrospective audit. Statistical analysis included analysis of variance and pair-wise comparisons. Surgeons performed the surgery as clinically warranted, and no alteration was made of standard postoperative care or physiotherapy.

Of the 113 patients audited, the anterior approach for THR was found to be associated with a shorter length of stay in hospital when compared to both posterior approach (p=.0039) and lateral approach (p = .0512). The average length of stay after elective THR replacement was 6.9 days. The average length of stay for each approach was 4.3 days, 8.4 days and 6.4 days for anterior, posterior and lateral approach respectively. No significant difference was associated between operative approach and age.

Anterior approach to THR was associated with a shorter length of hospital stay.