Hip Replacement in a High Volume Community Hospital: Effect on Length of Stay and Hospital Cost

Introduction of the Direct Anterior Approach to Hip Replacement Into a High Volume Community Hospital: Effect on Length of Stay and Hospital Cost

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.

Inclusion Criteria:

1. Consecutive single surgeon series of patients who have undergone primary uncemented hip replacement at our institution through either a posterior approach or direct anterior approach on a fracture table. Posterior approach patient - most recent patient prior to March, 2010, compared with consecutive recent anterior approach patients with minimum of 6 month follow-up.
2. Diagnosis of osteoarthritis, inflammatory arthritis, or avascular necrosis.
3. No previous surgery on affected hip.
4. Age 40-90 at time of surgery

Exclusion Criteria:

1. Patient not permitted to bear full weight after the procedure, per post operative instructions
2. Hip replacement performed for acute fracture.
3. Previous hip surgery.