A comparative health care inventory for primary hip arthroplasty between Germany versus the Netherlands. Is there a downside effect to fast-track surgery with regard to patient satisfaction and functional outcome?

2019 ◽  
Vol 30 (4) ◽  
pp. 423-430 ◽  
Author(s):  
Wout Füssenich ◽  
Davey MJM Gerhardt ◽  
Thomas Pauly ◽  
Frank Lorenz ◽  
Martin Olieslagers ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
The Netherlands ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Cost Estimation ◽  
Fast Track ◽  
Border Region ◽  
Fast Track Surgery ◽  
Global Cost

Background: Treatment and rehabilitation protocol for hip arthroplasty differs between Germany and the Netherlands. The Dutch system promotes fast-track surgery whereas in Germany conventional care is provided with a longer hospital stay including rehabilitation. Clinical outcome, patient satisfaction and costs in both treatment protocols were compared in a prospective setup. Material and methods: This prospective cohort study included patients allocated for primary THA in 3 German and 1 Dutch hospital in the border region. Patient-reported outcome scores (PROMS) were measured pre- and postoperatively at 6 and 12 months including the Oxford Hip Score, SF12 survey, visual analogue scale for satisfaction and pain. Length of hospitalisation and availability of postoperative rehabilitation were recorded. In addition, a total cost estimation was calculated using health insurers data. Results: A total of 360 consecutive patients were included; 175 THA in Germany compared to 185 THA in the Netherlands. No cross-border healthcare was encountered in both cohorts. Mean length of hospitalisation was 11.3 (range 6–23) days in Germany, compared to 4.4 (range 3–25) days in the Netherlands. In Germany 92% of the patients was discharged with inpatient (72%) or outpatient (20%) rehabilitation, compared to 21% with only inpatient rehabilitation in the Netherlands. No significant differences were measured regarding the PROMS and patient satisfaction between both countries. Due to profound differences in health care financing only a global cost estimation could be made and no major differences were encountered. Conclusion: Germany and the Netherlands both offer highly protocolled care for THA with comparable functional outcome and patient satisfaction with treatment after 12 months. Despite the length of hospitalisation in Germany is significantly longer including a more intensive rehabilitation programme, no significant differences were recorded regarding functional outcome nor patient satisfaction compared to fast-track surgery performed in the Netherlands.

scholarly journals Excellent Functional Outcome and Quality of Life after Primary Cementless Total Hip Arthroplasty (THA) Using an Enhanced Recovery Setup

2021 ◽  
Vol 10 (4) ◽  
pp. 621
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Günther Maderbacher ◽  
Matthias Meyer ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Enhanced Recovery ◽  
Harris Hip Score ◽  
Total Hip ◽  
Cementless Total Hip Arthroplasty

Background: Total hip arthroplasty combined with the concept of enhanced recovery is of continued worldwide interest, as it is reported to improve early functional outcome and treatment quality without increasing complications. The aim of the study was to investigate functional outcome and quality of life 4 weeks and 12 months after cementless total hip arthroplasty in combination with an enhanced recovery concept. Methods: A total of 109 patients underwent primary cementless Total Hip Arthroplasty (THA) in an enhanced recovery concept and were retrospectively analyzed. After 4 weeks and 12 months, clinical examination was analyzed regarding function, pain and satisfaction; results were evaluated using Harris Hip score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EQ-5D-5L, EQ-VAS and subjective patient-related outcome measures (PROMs). Preoperatively, HADS (Hospital Anxiety and Depression Scale) was collected. A correlation analysis of age, American Society of Anesthesiologists (ASA), HADS and comorbidities (diabetes mellitus, art. hypertension, cardiovascular disease) with WOMAC, Harris Hip score (HHS) and EQ-5D was performed. Results: Patients showed a significant improvement in Harris Hip score 4 weeks and 12 months postoperatively (p < 0.001). WOMAC total score, subscale pain, subscale stiffness and subscale function improved significantly from preoperative to 12 months postoperative (p < 0.001). EQ-5D showed a significant improvement preoperative to postoperative (p < 0.001). The influence of anxiety or depression (HADS-A or HADS-D) on functional outcome could not be determined. There was a high patient satisfaction postoperatively, and almost 100% of patients would choose enhanced recovery surgery again. Conclusion: Cementless THA with the concept of enhanced recovery improves early clinical function and quality of life. PROMs showed a continuous improvement over a follow-up of 12 months after surgery. PROMs can help patients and surgeons to modify expectations and improve patient satisfaction.

Operative approach influences functional outcome after DAIR for infected total hip arthroplasty

2020 ◽  
Vol 102-B (12) ◽  
pp. 1662-1669
Author(s):  
Christian T. Pollmann ◽  
Jan-Erik Gjertsen ◽  
Håvard Dale ◽  
Truls M. Straume-Næsheim ◽  
Eva Dybvik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Deep Infection ◽  
Operative Approach ◽  
Function Score ◽  
Womac Function ◽  
Approach Group

Aims To compare the functional outcome, health-related quality of life (HRQoL), and satisfaction of patients who underwent primary total hip arthroplasty (THA) and a single debridement, antibiotics and implant retention (DAIR) procedure for deep infection, using either the transgluteal or the posterior surgical approach for both procedures. Methods The study was registered at clinicaltrials.gov (ID: NCT03161990) on 15 May 2017. Patients treated with a single DAIR procedure for deep infection through the same operative approach as their primary THA (either the transgluteal or the posterior approach) were identified in the Norwegian Arthroplasty Register and given a questionnaire. Median follow-up after DAIR by questionnaire was 5.5 years in the transgluteal group (n = 87) and 2.5 years in the posterior approach group (n = 102). Results Patients in the posterior approach group were less likely to limp after the DAIR procedure (17% vs 36% limped all the time; p = 0.005), had a higher mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function score (80 vs 71; p = 0.013), and were more likely to achieve a patient acceptable symptom state for the WOMAC function score (76% vs 55%; p = 0.002). In a multivariable analysis, the point estimate for the increase in WOMAC function score using the posterior approach was 10.2 (95% CI 3.1 to 17.2; p = 0.005), which is above the minimal clinically important improvement. The patients in the posterior approach group also reported better mean HRQoL scores and were more likely to be satisfied with their hip arthroplasty (77% vs 55%; p = 0.001). Conclusion In patients treated with a single, successful DAIR procedure for deep infection of a primary THA, the use of the posterior approach in both primary surgery and DAIR was associated with less limping, better functional outcome, better HRQoL, and higher patient satisfaction compared with cases where both were performed using the transgluteal approach. The observed differences in functional outcome and patient satisfaction were clinically relevant. Cite this article: Bone Joint J 2020;102-B(12):1662–1669.

Implementation of fast-track surgery program in total hip arthroplasty

2016 ◽  
Vol 102 (7) ◽  
pp. S89-S90
Author(s):  
João Duarte Silva ◽  
Bernardo Nunes ◽  
Mariana Ferreira ◽  
Manuel Seara ◽  
António Mateus ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fast Track ◽  
Fast Track Surgery ◽  
Total Hip

scholarly journals Impacts of the perioperative fast track surgery concept on the physical and psychological rehabilitation of total hip arthroplasty

Medicine ◽  
2021 ◽  
Vol 100 (32) ◽  
pp. e26869
Author(s):  
Meiyan Zhong ◽  
Dehuai Liu ◽  
Haijun Tang ◽  
Yadong Zheng ◽  
Yu Bai ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Fast Track ◽  
Fast Track Surgery ◽  
Total Hip

scholarly journals Robotic arm-assisted versus manual total hip arthroplasty

2021 ◽  
Vol 10 (1) ◽  
pp. 22-30
Author(s):  
Nicholas D. Clement ◽  
Paul Gaston ◽  
Allison Bell ◽  
Philip Simpson ◽  
Gavin Macpherson ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Health Improvement ◽  
Leg Length ◽  
Total Hip ◽  
Oxford Hip Score ◽  
Five Dimension ◽  
Safe Zones

Aims The primary aim of this study was to compare the hip-specific functional outcome of robotic assisted total hip arthroplasty (rTHA) with manual total hip arthroplasty (mTHA) in patients with osteoarthritis (OA). Secondary aims were to compare general health improvement, patient satisfaction, and radiological component position and restoration of leg length between rTHA and mTHA. Methods A total of 40 patients undergoing rTHA were propensity score matched to 80 patients undergoing mTHA for OA. Patients were matched for age, sex, and preoperative function. The Oxford Hip Score (OHS), Forgotten Joint Score (FJS), and EuroQol five-dimension questionnaire (EQ-5D) were collected pre- and postoperatively (mean 10 months (SD 2.2) in rTHA group and 12 months (SD 0.3) in mTHA group). In addition, patient satisfaction was collected postoperatively. Component accuracy was assessed using Lewinnek and Callanan safe zones, and restoration of leg length were assessed radiologically. Results There were no significant differences in the preoperative demographics (p ≥ 0.781) or function (p ≥ 0.383) between the groups. The postoperative OHS (difference 2.5, 95% confidence interval (CI) 0.1 to 4.8; p = 0.038) and FJS (difference 21.1, 95% CI 10.7 to 31.5; p < 0.001) were significantly greater in the rTHA group when compared with the mTHA group. However, only the FJS was clinically significantly greater. There was no difference in the postoperative EQ-5D (difference 0.017, 95% CI -0.042 to 0.077; p = 0.562) between the two groups. No patients were dissatisfied in the rTHA group whereas six were dissatisfied in the mTHA group, but this was not significant (p = 0.176). rTHA was associated with an overall greater rate of component positioning in a safe zone (p ≤ 0.003) and restoration of leg length (p < 0.001). Conclusion Patients undergoing rTHA had a greater hip-specific functional outcome when compared to mTHA, which may be related to improved component positioning and restoration of leg length. However, there was no difference in their postoperative generic health or rate of satisfaction. Cite this article: Bone Joint Res 2021;10(1):22–30.

The Impact of Leg Length Discrepancy on Patient Satisfaction and Functional Outcome Following Total Hip Arthroplasty

2013 ◽  
Vol 28 (8) ◽  
pp. 1408-1414 ◽  
Author(s):  
Michael R. Whitehouse ◽  
Natalija S. Stefanovich-Lawbuary ◽  
Luke R. Brunton ◽  
Ashley W. Blom
Keyword(s):  
Patient Satisfaction ◽  
Total Hip Arthroplasty ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Leg Length Discrepancy ◽  
Leg Length ◽  
Total Hip ◽  
Length Discrepancy ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document