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1000 Titel
  • Implementing fast-track in total hip arthroplasty: rapid mobilization with low need for pain medication and low pain values
1000 Titelzusatz
  • Einführung von Fast-Track in der Hüftgelenkendoprothetik: frühpostoperative Mobilisation mit geringem Analgetikabedarf und niedrigen Schmerzwerten
1000 Autor/in
  1. Götz, Julia Sabrina |
  2. Leiss, Franziska |
  3. Maderbacher, Günther |
  4. Meyer, Matthias |
  5. Reinhard, Jan |
  6. Zeman, Florian |
  7. Grifka, Joachim |
  8. Greimel, Felix |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-03-11
1000 Erschienen in
1000 Quellenangabe
  • 81(3):253-262
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00393-021-00978-5 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8967758/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Introduction!#!Total hip arthroplasty (THA) is reported to be one of the most painful surgical procedures. Perioperative management and rehabilitation patterns are of great importance for the success of the procedure. The aim of this cohort study was the evaluation of function, mobilization and pain scores during the inpatient stay (6 days postoperatively) and 4 weeks after fast-track THA.!##!Materials and methods!#!A total of 102 consecutive patients were included in this retrospective cohort trial after minimally invasive cementless total hip arthroplasty under spinal anesthesia in a fast-track setup. The extent of mobilization under full-weight-bearing with crutches (walking distance in meters and necessity of nurse aid) and pain values using a numerical rating scale (NRS) were measured. Function was evaluated measuring the range of motion (ROM) and the ability of sitting on a chair, walking and personal hygiene. Furthermore, circumferences of thighs were measured to evaluate the extent of postoperative swelling. The widespread Harris Hip Score (HHS) was used to compare results pre- and 4 weeks postoperatively.!##!Results!#!Evaluation of pain scores in the postoperative course showed a constant decrease in the first postoperative week (days 1-6 postoperatively). The pain scores before surgery were significantly higher than surgery (day 6), during mobilization (p < 0.001), at rest (p < 0.001) and at night (p < 0.001). All patients were able to mobilize on the day of surgery. In addition, there was a significant improvement in independent activities within the first 6 days postoperatively: sitting on a chair (p < 0.001), walking (p < 0.001) and personal hygiene (p < 0.001). There was no significant difference between the measured preoperative and postoperative (day 6 after surgery) thigh circumferences above the knee joint. Compared to preoperatively, there was a significant (p < 0.001) improvement of the HHS 4 weeks after surgery. In 100% of the cases, the operation was reported to be successful and all of the treated patients would choose a fast-track setup again.!##!Conclusion!#!Application of a fast-track scheme is effective regarding function and mobilization of patients. Low pain values and rapid improvement of walking distance confirms the success of the fast-track concept in the immediate postoperative course. Future prospective studies have to confirm the results comparing a conventional and a fast-track pathway.
1000 Sacherschließung
lokal Arthroplasty, Replacement, Hip/rehabilitation [MeSH]
lokal Rasche Rekonvaleszenz
lokal Total hip arthroplasty
lokal Range of motion
lokal Humans [MeSH]
lokal Prospective Studies [MeSH]
lokal Treatment Outcome [MeSH]
lokal Pain management
lokal Fast-frack
lokal Retrospective Studies [MeSH]
lokal Enhanced recovery
lokal Fast-Track
lokal Cohort Studies [MeSH]
lokal Schmerz-Management
lokal Pain [MeSH]
lokal Beweglichkeit
lokal Originalien
lokal Arthroplasty, Replacement, Hip/methods [MeSH]
lokal Arthroplasty, Replacement, Hip/adverse effects [MeSH]
lokal Hüftgelenktotalendoprothetik
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/R8O2dHosIEp1bGlhIFNhYnJpbmE=|https://frl.publisso.de/adhoc/uri/TGVpc3MsIEZyYW56aXNrYQ==|https://frl.publisso.de/adhoc/uri/TWFkZXJiYWNoZXIsIEfDvG50aGVy|https://frl.publisso.de/adhoc/uri/TWV5ZXIsIE1hdHRoaWFz|https://frl.publisso.de/adhoc/uri/UmVpbmhhcmQsIEphbg==|https://frl.publisso.de/adhoc/uri/WmVtYW4sIEZsb3JpYW4=|https://frl.publisso.de/adhoc/uri/R3JpZmthLCBKb2FjaGlt|https://frl.publisso.de/adhoc/uri/R3JlaW1lbCwgRmVsaXg=
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