Efficacy of fast-track surgery combined with standard rehabilitation training in elderly patients after total hip arthroplasty

Abstract

Objective To explore the efficacy of fast-track surgery(FTS)combined with standard rehabilitation program(HSS)in elderly patients undergoing total hip arthroplasty(THA). Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FTS plus HSS rehabilitation program(experimental group, n=45)or HSS rehabilitation program(control group, n=45)after THA from December 2013 to December 2014 in our hospital. The experimental group had 23 men and 22 women, with an average age of 68. 2 ±3. 7 years. The control group had 22 men and 23 women, with an average age of 70. 6 ±4. 1 years. Harris score and visual analogue scale(VAS)were used to assess the hip joint function before operation, 4, 8 and 14 weeks after operation. The complications were compared between the 2 groups at 14 weeks after operation. Results All the patients completed a 14-week follow-up. There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups(P> 0. 05). At 4, 8 and 14 weeks after operation, the Harris scores in the experimental group(67. 2 ±3. 5, 88. 3 ±2. 5 and 92. 5 ±3. 3)were significantly higher than those in the control group(52. 5 ±7. 8, 65. 8 ±4. 9 and 72. 2 ±4. 9)and the VAS scores in the experimental group(3. 4 ±0. 8, 2. 2 ±0. 8 and 1. 3 ±0.5)were significantly lower than those in the control group(5. 6 ±0. 9, 4. 2 ±0. 8 and 2. 9 ±0. 8)(P> 0. 05). There were no complications in the experiment group while there were 14 complications(31. 1%)in the control group, showing a significant difference(P<0. 05). Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA. Key words: Arthroplasty, replacement, hip; Femoral neck fractures; Hospital, rehabilitation; Aged