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Funding
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| Name | Class |
|---|---|
| DePuy Orthopaedics | INDUSTRY |
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The investigators propose to evaluate and compare the percentage of patients who are able to be discharged in less than 3 days after undergoing total hip arthroscopy through either a direct anterior or posterior approach, utilizing the identical post operative protocol. The investigators also propose to evaluate the costs associated with the two different approaches to hip replacement in the same group of patients. Post operative resource utilization, discharge disposition, and pain medicine requirement will also be evaluated.
The investigators hypothesize that a higher proportion of patients treated with the direct anterior approach for hip replacement will be able to leave the hospital in less than 3 days when compared with a less invasive posterior approach. Secondly, decreased length of stay associated with the procedure may reduce hospital costs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Direct Anterior Approach hip replacement | Single surgeon series of 105 consecutive patients who underwent hip replacement via the direct anterior approach on a fracture table | ||
| Posterior Approach Hip Replacement | 105 consecutive patients previously operated on by a less invasive posterior approach at the same institution. These surgeries occurred prior to March, 2010. |
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| Measure | Description | Time Frame |
|---|---|---|
| Length of Hospital Stay | The length of stay and proportion of patients who went home in less than 3 days will be determined for each group. To evaluate and compare the percentage of patients who are able to be discharged in less than 3 days after undergoing total hip arthroscopy through either a direct anterior or posterior approach, utilizing the identical post operative protocol. | Retrospective review of hospital discharge records |
| Hospital cost | Hospital cost analysis will be undertaken for each group. | Retrospective review of utilization records |
| Measure | Description | Time Frame |
|---|---|---|
| Post Operative Pain Medication Utilization | Analysis of post operative pain medicine requirement will be compared for the two groups. | After retrospective chart review is complete -- approximately 6 months |
| Utilization of inpatient physical therapy resources |
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Inclusion Criteria:
Exclusion Criteria:
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Patients who have undergone primary uncemented hip replacement at our institution (Anne Arundel Medical Center) through either a posterior approach or direct anterior approach on a fracture table utilizing the identical post operative protocol.
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| Name | Affiliation | Role |
|---|---|---|
| Paul King, M.D. | Anne Arundel Medical Center / Anne Arundel Orthopedic Surgeons | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Anne Arundel Medical Center | Annapolis | Maryland | 21401 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 10884204 | Background | Hayes JH, Cleary R, Gillespie WJ, Pinder IM, Sher JL. Are clinical and patient assessed outcomes affected by reducing length of hospital stay for total hip arthroplasty? J Arthroplasty. 2000 Jun;15(4):448-52. doi: 10.1054/arth.2000.4346. | |
| 21723700 | Background | Vorhies JS, Wang Y, Herndon J, Maloney WJ, Huddleston JI. Readmission and length of stay after total hip arthroplasty in a national Medicare sample. J Arthroplasty. 2011 Sep;26(6 Suppl):119-23. doi: 10.1016/j.arth.2011.04.036. Epub 2011 Jul 1. |
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| ID | Term |
|---|---|
| D015207 | Osteoarthritis, Hip |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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Utilization of inpatient physical therapy resources and post hospital discharge disposition will be compared for the two groups. |
| Retrospective review -- of hospital discharge |
| 21051190 | Background | Duwelius PJ, Moller HS, Burkhart RL, Waller F, Wu Y, Grunkemeier GL. The economic impact of minimally invasive total hip arthroplasty. J Arthroplasty. 2011 Sep;26(6):883-5. doi: 10.1016/j.arth.2010.09.011. Epub 2010 Nov 3. |
| 16190055 | Background | Matta JM, Ferguson TA. The anterior approach for hip replacement. Orthopedics. 2005 Sep;28(9):927-8. doi: 10.3928/0147-7447-20050901-11. No abstract available. |
| 16330993 | Background | Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res. 2005 Dec;441:115-24. doi: 10.1097/01.blo.0000194309.70518.cb. |
| D012216 |
| Rheumatic Diseases |