Fast track in total hip and knee arthroplasty - experiences from Hvidovre University Hospital, Denmark

This study investigated whether unselected patients operated on with total hip arthroplasty (THA) or total knee arthroplasty (TKA) could accomplish a self-developed accelerated track, ANORAK-HH, with a planned length of stay (LOS) of maximum 5 days and patient satisfaction at all parts of the track. 307 patients who sustained 329 hip and knee arthroplasties were included in the study with the main material constituted from 243 primary unilateral THA and TKA arthroplasties. ANORAK-HH includes pre-operative patient clinic, patient motivation, dedicated staff, unchanged criteria for discharge and a planned LOS of maximum 5 days. 22 patient characteristics and 11 satisfaction parameters were registered as well as readmissions within 3 months. 95% of patients had a LOS of maximum 5 days with a mean of 3.9 days. Median and mean values of satisfaction for the entire track were 10 and 9.4 out of 10, respectively. Participation in patient clinic did not influence LOS or satisfaction. Operations at the beginning of the week and tack of blood transfusion were associated with shorter LOS. Finally, ANORAK-HH could be effectively accomplished in. unselected THA and TKA patients without having an adverse effect on patient readmission rate. (C) 2006 Elsevier Ltd. All rights reserved.