Outpatient Total Joint Arthroplasty in Dedicated Daycare Facility vs Standard Patient Ward

Not Applicable

Completed

• Conditions: Arthropathy of Knee; Arthropathy of Hip
• Interventions: Other: Mobilization at a dedicated daycare facility

• Registration Number: NCT03896282
• Lead Sponsor: Hvidovre University Hospital

Brief Summary

The purpose of this single center randomized controlled trial (RCT) is to investigate whether outpatient arthroplasty surgery in a dedicated daycare facility will improve discharge on day of surgery, as opposed to surgery followed by subsequent stay in the ward and also same day discharge, without compromizing safety and outcome.

Detailed Description

Introduction of fast-track total hip arthroplasty (THA) and total knee arthroplasty (TKA) has led to a decrease in length of stay without compromising patient safety and clinical outcome . In recent years outpatient THA and TKA has gained popularity, especially as major focus is placed on reducing cost and increasing efficiency in all medical treatments . Studies have shown outpatient arthroplasty to be feasible both for THA and TKA patients , with up to 70% of unselected patients being potentially eligible for outpatient surgery. Various results are published on success rate of discharged patients on the day of surgery, ranging from 25% to 99% , depending on patient selection and logistic setup. While the majority of published studies utilizes a modern fast-track setup with early mobilization and multimodal pain treatment, the optimal logistic setup remains unknown.

The purpose of this single center randomized controlled trial (RCT) is to investigate whether outpatient arthroplasty surgery in a dedicated daycare facility will improve discharge on day of surgery, as opposed to surgery followed by subsequent stay in the ward and also same day discharge, without compromizing safety and outcome.

Study Timeline

• Study Start: 2017-08-01
• Primary Completion: 2018-11-01
• Study First Submitted: 2019-03-27
• Study First Submitted QC: 2019-03-28
• Study First Posted: 2019-03-29
• Study Completion: 2020-02-01
• Status Verified: 2020-07
• Last Update Submitted: 2020-07-29
• Last Update Posted: 2020-07-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

• Patients with clinical and radiological osteoarthritis of the hip suitable for primary cementless THA and patients with clinical and radiological osteoarthritis of the knee suitable for primary Cruciate Retaining (CR) TKA
• Age 18-80
• American Society of Anesthesiologists (ASA) Score (1-2)
• BMI <35
• Interested in and motivated for same day discharge
• Family or relatives to be present for >24 hours after discharge
• Able to understand and give consent to the study

Exclusion Criteria

• Unable to provide care at own home on day of surgery for >24 hours after discharge

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
daycare facility	Mobilization at a dedicated daycare facility	After surgery patient stay at daycare facility for mobilisation and stay until discharge or transfer to standard patient ward if nor discharged by 20.000
standard patient ward	Mobilization at a dedicated daycare facility	After surgery patients are transferred to standard patient ward for mobilisation and stay until discharge.

Primary Outcome Measures

Name	Time	Method
Patients discharged on day of surgery	12 hours	Success rate of discharge on day of surgery

Secondary Outcome Measures

Name	Time	Method
Readmissions	3 months	Readmissions within 90 days
reoperations	3 months	reoperations within 90 days
Patient reported outcomes	3 months	Total Oxford knee score (0-48, with 0 being worst and 48 best)

Trial Locations

Locations (1)

Dept. of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre; 🇩🇰 Hvidovre, Denmark