Outpatient total hip arthroplasty (THA) has remained controversial and challenging. Traditional hospital stays following total joint arthroplasty were substantial and resulted in increased rates of morbidity, significant pain, and severe restriction in mobility. Advancements in the surgical approach, anesthetic regimens, and the initiation of rapid rehabilitation protocols have had an impact on the length of recovery following elective THA. Still, very few studies have specifically outlined outpatient hip arthroplasty and, thus far, none have addressed the use of robotic-arm navigation in outpatient THA. This article describes in detail the technique used to perform outpatient THA with the use of robotic-arm assistance. We believe that outpatient THA using robotic-arm assistance in combination with tissue-preserving surgery, multi-modal pain and nausea management, early rehabilitation, and stringent patient selection yields a suitable alternative to inpatient joint replacement.

This retrospective study evaluated 69 Swanson trapezium replacements performed between 1990 and 2009 for trapeziometacarpal osteoarthritis in 58 patients. Pain and function were assessed using the Michigan Hand Questionnaire (MHQ) and the Disability of the Arm, Shoulder and Hand (DASH) questionnaire. Patients had a mean age of 62 years at the time of surgery, with a mean time of 7.7 years from time of surgery to completion of the follow-up interview. The results showed good relief of pain and function with no significant deterioration with time from surgery. There were no gender differences or differences by age. The only differences observed were that those patients following surgery on a dominant hand indicated higher activities of daily living and work related activities. The authors conclude silicone trapezium replacement remains a good option for patients with painful trapeziometacarpal osteoarthritis that has not responded to non-operative treatment.

Hypothesis

Athletes significantly alter their lumbar spinal motion when performing squat lifting at heavy weights. This altered motion effects a change in pressure in the posterior annulus of lumbar discs.