ArticleActa orthopaedica2018
Reduced length of uninterrupted institutional stay after implementing a fast-track protocol for primary total hip replacement.
Article in Acta orthopaedica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Economic analyses of fast-track total hip and knee arthroplasty: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2020Pooled it
- Coordinated Return-to-Work model reduces sickness absences after hip or knee arthroplasty: a registry-based study.Archives of orthopaedic and trauma surgery · 2026Article
- Return to Work Following Hip or Knee Arthroplasty: A One-Year Prospective Cohort Study in Participants with Direct Referral from Hospital to Occupational Health Care Services.Journal of occupational rehabilitation · 2025Article
- The incidence of venous thromboembolism is low when risk stratification-based thromboprophylaxis is used after fast-track hip and knee arthroplasty.BMC musculoskeletal disorders · 2024Article
- Venous thromboembolism is rare after total hip and knee joint arthroplasty with long thromboprophylaxis in Finnish fast-track hospitals.Archives of orthopaedic and trauma surgery · 2023Article
- Fast Track Protocols and Early Rehabilitation after Surgery in Total Hip Arthroplasty: A Narrative Review.Clinics and practice · 2023Review
- Excellent PROM results after fast-track hip and knee arthroplasty with no postoperative restrictions: a cohort study validation of fast-track surgery without postoperative restrictions.BMC musculoskeletal disorders · 2022Article
- Low incidence of clinically relevant bleeding complications after fast-track arthroplasty: a register study of 8,511 arthroplasties.Acta orthopaedica · 2022Article
- Converting hip and knee arthroplasty cases to same-day surgery due to COVID-19.Bone & joint open · 2021Article
- Fast-Track Programs in Total Hip and Knee Replacement at Swedish Hospitals-Influence on 2-Year Risk of Revision and Mortality.Journal of clinical medicine · 2021Article
- Prolonged length of stay (PLOS) in a high-volume arthroplasty unit.Bone & joint open · 2020Article
- Short stay total joint arthroplasty program: patient factors predicting readmissionCanadian journal of surgery. Journal canadien de chirurgie · 2019Article
- Observational
- Fast-tracking for total knee replacement reduces use of institutional care without compromising quality.Acta orthopaedica · 2018Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and purpose - Fast-track protocols have been successfully implemented in many hospitals as they have been shown to result in shorter length of stay (LOS) without compromising results. We evaluated the effect of fast-track implementation on the use of institutional care and results after total hip replacement (THR). Patients and methods - 3,193 THRs performed in 4 hospitals between 2009-2010 and 2012-2013 were identified from the Finnish Hospital Discharge Register and the Finnish Arthroplasty Register. Hospitals were classified as fast-track (Hospital A) and non-fast-track (Hospitals B, C, and D). We analyzed LOS, length of uninterrupted institutional care (LUIC, including LOS), discharge destination, readmission, revision rate, and mortality in each hospital. We compared these outcomes for THRs performed in Hospital A before and after fast-track implementation and we also compared outcomes, excluding readmission rates, with the corresponding outcomes for the other hospitals. Results - After fast-track implementation, median LOS in Hospital A diminished from 5 to 2 days (p < 0.001) and (median) LUIC from 6 to 3 (p = 0.001) days. No statistically significant changes occurred in discharge destination. However, the reduction in LOS was combined with an increase in the 42-day readmission rate (3.1% to 8.3%) (p < 0.001). A higher proportion of patients were at home 1 week after THR (p < 0.001) in Hospital A after fast-tracking than before. Interpretation - The fast-track protocol reduces LUIC but needs careful implementation to maintain good quality of care throughout the treatment process.
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