Reducing hospital length of stay following total hip and knee replacement surgery with a dedicated fast track program

Abstract

Background: Dedicated joint replacement programs are being developed to determine their efficacy in decreasing costs and overall demand on the medical system. This study aimed to determine if a dedicated multidisciplinary joint replacement program can reduce postoperative length of stay while maintaining acceptable levels of safety and patient satisfaction, reducing the overall demand and burden on the medical system. Methods: A prospective cohort study was performed on 318 selected patients who had total knee or hip replacement surgery as part of a dedicated multidisciplinary program. The program used a multidisciplinary best practice approach for the patient process. Results: For the 150 patients who had total hip replacement and 168 who had total knee replacement, the mean length of stay was 2.14 (1-11) days and 1.87 (0-8), respectively. Being female, having a hip replacement, increasing age, and higher body mass index were all associated with a length of stay over 2 days. Conclusions: This program was effective at reducing postoperative length of stay for both hip and knee replacement surgeries. This analysis suggests that a dedicated multidisciplinary program is appropriate to decrease length of hospital stay in face of increasing demand. Therefore, it has the potential to serve as a model for other centers to develop similar multidisciplinary programs to help reduce the burden of joint replacements on the health care system.