Direct Anterior Total Hip Arthroplasty (THA), in Versus Outpatients : A Prospective Monocentric Study in Rennes University Hospital.

Direct Anterior Total Hip Arthroplasty (THA), in Versus Outpatients : A Prospective Monocentric Study in Rennes University Hospital.

The main objective is to show that cumulative length of stay over the first 45 post operative days (i.e. : primary length of stay and readmission) is significantly lower in the outpatients group than in the inpatients group

Inclusion Criteria:

• Unilateral primary total hip arthroplasty for hip osteoarthritis, primary or secondary osteoarthritis (dysplasia or post-traumatic) or osteonecrosis
• Good enough understanding of outpatient management and patient adherence to post-operative instructions
• Sufficient patient complicance to medical orders
• Living and hygiene conditions, at least, equivalent to the ones the hospital provides
• To be of age
• Non opposition to the protocole participation

Outpatients group :

- Patient schedulded to undergo outpatient THA

Inpatients group :

- Patient schedulded to undergo inpatient THA because of not fiting the following items :

• Less than an hour distance of a Health Center that provides appropriate care with regard to the surgery
• Rapid access to a phone
• Designated driver and caretaker available (at least the first night after discharge from the hospital) after the procedure Or turning down outpatient THA

Exclusion Criteria:

• Anaesthetic point of view :

  • ASA physical status ≥ 3 and : unstabilize disease with appropriate treatment or lack of preoperative mutual agreement between anesthesiologist and surgeon or not inconsiderable interaction between the operation and the disease or its treatment
  • Pre-operative Hb < 12 (♀) < 13 (♂) g/L (NB : no Hb control before discharge except if excessive blood loss ; Hb < 10g/L contraindicates outpatient surgery)
  • Opioid chronic pre-operative therapy or opioid addiction

• Surgical point of view :

  • Ambulatory pre-operative status requiring use of two crutches or walking frame / distance walked < 30 m
  • THA procedure for femoral neck fracture requiring
  • Additional operative technic needed

• Adult safeguarding.

Exclusion criteria applies to all in and outpatients.