Hip Replacement Surgery Research Articles

Assessing the Relationship between Hospital Process Digitalization and Hospital Quality – Evidence from Germany

Hospital digitalization aims to increase efficiency, reduce costs, and/ or improve quality of care. To assess a digitalization-quality relationship, we investigate the association between process digitalization and process and outcome quality. We use data from the German DigitalRadar (DR) project from 2021 and combine these data with two process (preoperative waiting time for osteosynthesis and hip replacement surgery after femur fracture, n = 516 and 574) and two outcome quality indicators (mortality ratio of patients hospitalized for outpatient-acquired pneumonia, n = 1,074; ratio of new decubitus cases, n = 1,519). For each indicator, we run a univariate and a multivariate regression. We measure process digitalization holistically by specifying three models with different explanatory variables: (1) the total DR-score (0 (not digitalized) to 100 (fully digitalized)), (2) the sum of DR-score sub-dimensions’ scores logically associated with an indicator, and (3) sub-dimensions’ separate scores. For the process quality indicators, all but one of the associations are insignificant. A greater DR-score is weakly associated with a lower mortality ratio of pneumonia patients (p < 0.10 in the multivariate regression). In contrast, higher process digitalization is significantly associated with a higher ratio of decubitus cases (p < 0.01 for models (1) and (2), p < 0.05 for two sub-dimensions in model (3)). Regarding decubitus, our finding might be due to better diagnosis, documentation, and reporting of decubitus cases due to digitalization rather than worse quality. Insignificant and inconclusive results might be due to the indicators’ inability to reflect quality variation and digitalization effects between hospitals. For future research, we recommend investigating within hospital effects with longitudinal data.

Stressors and coping strategies in older people hospitalised for hip surgery following a fall: a multiple case study

BackgroundMore than half of older persons admitted to an emergency department after a fall have a hip fracture and require surgery for a total hip replacement. This procedure has a high risk of postoperative complications and consequences for older persons, their informal caregivers, and the healthcare system. This study aimed to explore the perceptions of older persons, their informal caregivers and health professionals about intra-personal, inter-personal and extra-personal stressors arising from hip surgery following the fall of an older person hospitalised in orthopaedics, as well as the coping strategies used and the results obtained.MethodsA qualitative multiple case study. The sample consisted of eight cases. Each case consisted of one older person, their informal caregiver and the professionals involved in their care: a nurse, an orthopaedic surgeon and a physiotherapist. A total of 32 participants were recruited. Data were collected between August 2018 and February 2019 in a public hospital in French-speaking Switzerland. Intra- and inter-case analyses were performed.ResultsFive topics emerged: two concerning stressors for older persons (the physical and psychological consequences of the fall and hospitalisation; the loss of relational and environmental markers and habits); two relating to the coping strategies used to face the stressors (being resilient and involved in their own care; partially meeting the older person’s needs); and one regarding the results of the strategies used (reassurance through consideration of some of their needs).ConclusionsOlder persons hospitalised for hip surgery after a fall are confronted with various intra-, inter- and extra-personal stressors and have to explore, together with their informal caregivers, strategies to cope with the consequences of these stressors. Healthcare professionals should possess efficient intervention strategies to help identify and support older persons who experience various types of stressors during hospitalisation for hip surgery following a fall.

The Challenges and Strategies for Cleaning the Routinely Collected Data for Total Knee Replacements (TKR) and Total Hip Replacements (THR) in the Kingdom of Fife

Knee and hip replacement surgeries have revolutionised orthopaedic medicine by providing individuals with surgeries resulting in pain relief, improved mobility and a better quality of life. NHS Fife has been collecting routine data since 1998 on patient demographics, type of surgery, recovery time, follow-ups, revision, and outcomes, including complications. This work reports the challenges and strategies to clean the collected data. Data was available for 12,313 patients, totalising 14,524 THR and TKR surgeries performed in NHS Fife between 1998 and 2021. The original dataset consisted of 34 unique-structured files covering distinct periods and representing five categories: primary surgery, follow-up, infection, mortality, and revision. Data wrangling was done using the programming language R, transforming the raw data into a more functional form. The main elements of the data-cleaning procedure were combining variables representing the same information and converting void/corrupted/purposeless values into missing data, providing a standardisation for the collected information. Then, a rigorous data merging resulted in reshaping this complex collection of files into one single streamlined file for each of the five categories and type of surgery. Patients who had multiple surgeries were also cross-identifying, enabling the characterisation of the epidemiology of multiple lower limb joint replacements. The structured files can now be linked to studies across different datasets like social care, prescriptions, and primary care. It can also be used to develop future machine learning models to assess the risk of multiple primary and revision knee and hip replacements and their outcomes.

Dr. John H. Charnley: An Architect and Pioneer of the Modern Era of Hip Replacement Surgery.

Dr. John H. Charnley (1924-1982) revolutionized orthopedic surgery with his groundbreaking innovations in hip replacement with exceptional skill and a holistic thought process, which has had an impact to this day in the world of arthroplasty. His innovations have improved the lives of numerous patients who had painful and discomforting arthritis and have been instrumental in providing painless mobile joints to these patients. This article reviews Charnley's contributions to the development of low-friction arthroplasty using ultra-high-molecular-weight polyethylene and the use of acrylic bone cement for improved implant fixation. These advancements dealt with the critical issues of friction, wear, and implant stability, significantly enhancing patient outcomes and implant longevity. Charnley's work led to the global standardization of hip replacement procedures, influencing orthopedic practices globally and setting benchmarks for modern implant designs. His principles continue to inform ongoing research and advancements in hip replacement technology. This review also discusses the challenges and criticisms faced by Charnley's innovations, reflecting on their evolution and impact on contemporary orthopedic surgery. A surgeon blessed with a noble heart who would help his patients who were in trouble by going out of the way and was determined for a better tomorrow, self-driven by his compassion and ambition for treating his patients. Charnley's legacy remains pivotal in shaping the field and improving the quality of life for patients undergoing hip replacement surgery.

Effectiveness of Rehabilitation Program on Functional Ability among Patients Undergoing Total Hip Replacement Surgery

Effectiveness of Rehabilitation Program on Functional Ability among Patients Undergoing Total Hip Replacement Surgery

Stress-shielding in aseptic loosening on the 3D printed acetabular cup in hip arthroplasty: review article

The increasing number of prosthetic hip replacement surgeries and their growing indication have led to a growing interest in understanding the factors that influence their long-term success. Total hip arthroplasty (THA) failure is mainly due to aseptic loosening. More rarely septic mobilization may occur. In the first case, many variables influence the bone-implant relationship and periprosthetic bone remodeling. Stress-shielding is the most evident but not fully explained manifestation of the bone implant interaction. Recently, three-dimensional (3D) printed titanium orthopedic implants have offered new perspectives in the field of hip prosthetics, enabling the customization and production of acetabular cups with enhanced biocompatibility. This review aims to evaluate the efficacy and reliability of 3D printed acetabular cups from the perspective of aseptic failure particularly related to the stress-shielding. The most recent clinical and preclinical studies will be reviewed, exploring the benefits and challenges associated with the use of these emerging technologies. Key factors, such as biocompatibility, mechanical stability, osseointegration, and wear resistance.

Risk factors for prolonged length of hospital stay following elective hip replacement surgery: a retrospective longitudinal observational study

ObjectivesOur aim was to identify which patients are likely to stay in hospital longer following total hip replacement surgery.DesignLongitudinal, observational study used routinely collected data.SettingData were collected from an NHS...

Research progress of highly wear‐resistant and oxidation‐resistant polymer acetabular cup prosthesis

AbstractThe polymer‐based acetabular cup prosthesis, a vital component of hip replacement surgery, significantly contributes to the recovery of patients afflicted with osteoarthritic conditions. Nevertheless, the current clinical usage of polymer acetabular cup prostheses commonly encounters the challenge of balancing wear resistance and oxidation resistance, significantly impacting both their lifespan and patients′ quality of life. Consequently, researchers have persistently enhanced the attributes of polymer acetabular cup prosthetic materials. These enhancements, including irradiation and filler modifications, are intended to concurrently bolster both the wear and oxidation resistance of the prosthesis materials. This comprehensive approach aims to address wear‐associated clinical complications like osteolysis and oxidative brittleness, ultimately extending their in vivo service life. For this reason, this paper retrospectively discusses the progress of research on the modification of polymer acetabular cup prosthesis materials for high wear and oxidation resistance and explores potential design methods for optimising artificial acetabular cup materials, with a view to providing new ideas for extending the service life of artificial joint implants.

RETROSPECTIVE ANALYSIS OF PATIENT-REPORTED OUTCOME MEASURES IN A MATCHED COHORT OF INPATIENT AND DAY-SURGERY HIP ARTHROPLASTY PATIENTS

Most hip replacements are performed in an in-patient setting; however, there has been a shift in recent years in Canada towards doing more on an outpatient basis. In 2021–2022, 15.6% of hip replacements were performed as day surgeries compared to 0.7% in 2018–2019. This analysis will assess patient reported outcome measures of patients who had inpatient versus outpatient hip replacement surgery between 2018 and 2021.We analysed a retrospective sample of 4917 adult patients who had an elective primary unilateral hip replacement. Preoperative and three-month postoperative PROMs were completed - the Oxford Hip Score, EQD5L and patient satisfaction with the outcome were recorded. Patients who had an outpatient procedure were matched 1:1 with patients who are admitted to hospital for surgery based on age, sex and pre-COVID versus the COVID (March 15, 2020 as the start). Preoperative PROMs and Charlson Comorbidity Index were collected. T-tests and chi-square tests were used to assess the differences.The inpatient group on average was older, female and had a lower preoperative PROMs score and more comorbidities than the outpatient group. With cohort matching the sample consisted of 1244 patients. The inpatient and outpatient groups have similar Oxford scores, postoperative EQ-5D-5L scores and the proportion satisfied with their surgical results. The Oxford postoperative score was slightly higher in the outpatient group compared to the inpatient group; however, this is not clinically significant.We observed that outpatient protocols have no difference in patient satisfaction, self-reported functional outcomes and self-reported health-related quality of life three months after a hip replacement. Day surgery protocols represented potential solution to the challenges caused by the expected increase in demand for hip replacements. Our results demonstrated that patients do well clinically with day surgery procedures and there does not appear to be any detrimental effect on PROMs.

Alkaptonuria and Ochronotic Arthropathy: The Path to Pain-Free Mobility

This article discusses a case of ochronotic arthropathy, a manifestation of alkaptonuria. Alkaptonuria is characterized by the accumulation of homogentisic acid [HGA] in tissues, leading to a distinctive blue-black pigmentation and early joint degeneration. A 68-year-old female patient, with a history of alkaptonuria, presented with progressive hip pain and was eventually treated with an elective total hip replacement. Due to vertebral calcifications, the operation was performed under general anesthesia. Pre- and post-operative care was guided by the patient’s comorbidities and potential complications related to alkaptonuria, including potential cardiac and respiratory issues. Following surgery, the patient exhibited significant improvements in hip joint functionality. The paper also discusses the challenges in diagnosing alkaptonuria, the absence of definitive treatment, and the potential of dietary restrictions and symptomatic treatments. Moreover, it addresses surgical considerations for ochronotic arthropathy and emphasizes the role of regular calcium and vitamin D intake in maintaining bone quality. The success of the hip replacement surgery in this case suggests a potential intervention for managing ochronotic arthropathy in alkaptonuria patients.

Demand and capacity for hip and knee replacements in NHS Wales before the COVID-19 pandemic: implications for future planning

Background/Aims Joint replacement services in Wales were particularly affected by the COVID-19 pandemic, but waiting times had been high for several years before this. This study aimed to explore the hip and knee replacement activity in NHS Wales between 2000 and 2019 to indicate whether an existing gap between capacity and demand exacerbated the impact of the pandemic on waiting times. Methods A retrospective review was performed using publicly available databases, including the Patient Episode Database Wales and Stats Wales. Data relating to the number of hip and knee replacement operations performed between 2000 and 2019 and average waiting times were extracted and analysed. Data on the number of patients who underwent a hip or knee replacement during the study period after waiting over 36 weeks from referral were obtained by request to the Patient Episode Database Wales. Data were analysed descriptively. Results The 36-week referral to treatment target was not achieved for any year during the study period. Activity increased each year from 2000 to 2009, but varied substantially year to year afterwards. Average waiting times were at their lowest in 2009, but rose substantially after this point. Conclusions There had been a long-term lack of capacity for hip and knee replacements in NHS Wales for 20 years before 2020, which may have exacerbated the impact of the COVID-19 pandemic on waiting times for these services. Implementing more nuanced waiting time targets, based on the clinical effectiveness of procedures, may be more appropriate than blanket waiting time guarantees.

Analysis of risk factors for modification of femoral offset after internal fixation of Garden I and II femoral neck fractures

BackgroundThe concept of restoring the femoral offset is well established during hip replacement surgery, but is less well known when treating Garden I or II femoral neck fractures by internal fixation. And yet, the therapeutic aim for these fractures is to restore this native parameter as best possible. The aim of this study was to identify the risk factors for reduction of femoral offset after union of a Garden I or II femoral neck fracture treated by internal fixation. HypothesisAfter internal fixation of a femoral neck fracture, certain factors may contribute to reducing the femoral offset, which itself has been identified as being responsible for altering the patients’ quality of life and functional outcomes. Materials and methodsThis multicenter study included 193 patients who had a Garden I or II femoral neck fracture treated by cannulated screws or a sliding compression screw-plate. The difference between the femoral offset in the operated hip and that of the contralateral hip was measured in weightbearing patients after the fracture had healed. This difference was the primary outcome measure. Univariate and multivariate analyses were done to look for risk factors contributing to femoral neck shortening. ResultsBased on the univariate analysis, being more than 85 years of age, having a Garden I fracture, and cannulated screw fixation were associated with a significantly greater reduction in the femoral offset. In the multivariate analysis, only Garden I fractures were associated with a greater reduction in femoral offset. DiscussionGarden I fractures were associated with a greater reduction in the offset, although there was no evidence that this change was related to early weightbearing. By identifying this risk factor, surgeons can optimize the indications given that the treatment of these fractures is still widely debated and there is still no consensus as to the best method. Level of evidenceIV

Can Operating Room Design Make Orthopedic Surgeries Shorter, Safer, and More Efficient?: A Quasi-Experimental Study.

The study aimed to fill the knowledge gap about how operating room (OR) design could reduce orthopedic surgery duration and contribute to surgical care safety and efficiency. Long surgery duration may lead to delays and cancellations of surgeries, deteriorated patient experiences, postoperative complications, and waste of healthcare resources. The OR physical environment may contribute to the reduction of surgery duration by minimizing workflow disruptions and personnel movements during surgeries. Unobtrusive observations were conducted of 70 unilateral total knee or hip replacement surgeries in two differently designed ORs at a community hospital in the United States. A set of computer-based forms adapted from recent research was used to measure the surgery duration, environment-related disruptions, and ambulatory movements involving circulators. Potential confounding factors like surgery type were controlled in statistical analyses. Significantly shorter surgery durations were recorded in the larger OR with more clearances on both sides of the operating table, a wider door located on the sidewall, more cabinets, and more clearance between the circulator workstation and the sterile field (p =.019). The better-designed OR was also associated with less frequent disruptions and fewer movements per case (p < .001). Significant correlations existed between surgery duration, the number of disruptions, and the number of movements (rs = .576-.700, ps < .001). The study demonstrated the important role of OR physical environment in supporting the safe and efficient delivery of surgical care, which should be further enhanced through research and design innovations.

High Survival Rate and Satisfaction at More Than 11-Year Follow-Up After Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Impact of Preoperative Functional Scores, Osteoarthritis, and Chondrolabral Junction Damage on Failure

The purpose of the study was to investigate the survival and durability of clinical improvements following hip arthoscopy (HA) for femoroacetabular impingement syndrome (FAIS) at a minimum of 10-year follow-up. The primary objective was to determine the long-term survival, defined as: lack of conversion to total hip replacement (THR) or subsequent hip joint preservation surgery (HJPS). The secondary objective was to determine which preoperative factors were predictive of failure. Data from patients who underwent HA for FAIS between March 2003 and May 2012 were collected and retrospectively reviewed. Patients who underwent evaluation at a minimum 10-year follow-up, assessed according to hip outcome score - activities of daily living (HOS-ADL) and sport-specific subscale (HOS-SSS), and non-arthritic hip score (NAHS) were included. Satisfaction ratings were collected. Statistical analysis assessed within-group differences and survival. 95 patients with an average follow-up of 11.8 years were included. Mean age was 39.5 ± 11.0 years. Overall THR conversion rate was 24.2%, with a mean time of 3.4 ± 3.2 years. 3.2% required HJPS revision at a mean 3.2 ± 3 years. Survivorship was 72.6% at ten years. 28 patients (73.6% and 75.6%) achieved the minimal clinically important difference (MCID) for HOS-ADL and HOS-SSS, while 33 (84.6%) for NAHS. Patient Acceptable Symptom State (PASS) was achieved by 42 (61.7%), 43 (65.1%) and 44 (64.7%) patients respectively. Comparative analysis between patients who preserved their hip and those who underwent HJPS revision or THR highlighted that Tönnis ≥ 2, chondrolabral junction damage, and lower preoperative scores are associated with failure. HA for FAIS demonstrated durable results, with an accepatable THR conversion rate and sustained clinical benefits. 91.3% of the patients who preserved their hip were satisfied. Tönnis 2, MRA signs of chondrolabral junction damage and lower preoperative functional status are strongly associated with failure.

Health Technology Assessment for Fast-Track Elective Knee and Hip Arthroplasty in a High-Volume Orthopaedic Hospital in Italy.

The objective of the analysis presented is to assess the efficacy of a fast-track pathway for elective hip and knee arthroplasty, compared to the traditional approach, adopted within a research hospital located in Milan (Italy), in terms of length of stay reduction and related direct medical costs. A monocentric observational retrospective study was implemented considering adult subjects who underwent elective primary total hip or knee replacement, with a diagnosis of primary or secondary osteoarthritis. Exclusion criteria were subjects admitted via emergency department, subjects undergoing knee or hip replacement because of fractures or prosthesis revision. The analysis compared the length of stay and the direct medical costs, assuming the hospital perspective, of subjects admitted in the pre-fast-track period (years 2016/2017) and during the fast-track period (years 2018/2019). Knee replacement mean costs are 5,599 € (±1,158.3 €) in the pre-fast-track period and 4,487 € (±978.4 €) in the fast-track period (-1,112 €; -19.9%). Hip replacement mean costs in the pre-fast-track period are 5,364 € (±1,037.2 €) and 4,450 € (±843.7 €) in the fast-track period (-914 €; -17.0%). The adoption of fast-track pathway led to a statistically significant decrease of days of hospitalization of -2.8 (-37.6%) in knee replacement and of -2.9 (-39.2%) in hip replacement. The fast-track pathway adopted proved to be effective, reducing patients' length of stay, and sustainable and efficient, reducing direct medical costs, for both elective hip and knee replacement surgeries.

Gut microbiota-derived metabolite trimethylamine N-oxide aggravates cognitive dysfunction induced by femoral fracture operation in mice.

An increasing number of elderly individuals are experiencing postoperative cognitive dysfunction (POCD) problems after undergoing hip replacement surgery, with gut microbiota metabolites playing a role in its pathogenesis. Among these, the specific effects of trimethylamine N-oxide (TMAO) on POCD are still unclear. This study aimed to explore the role of TMAO on cognitive dysfunction and underlying mechanisms in mice. The POCD model was created through femoral fracture surgery in elderly mice, followed by cognitive function assessments using the Morris Water Maze and Novel Object Recognition tests. The gut microbiota depletion and fecal microbiota transplantation were performed to examine the relationship between TMAO levels and cognitive outcomes. The effects of TMAO treatment on cognitive dysfunction, microglial activation, and inflammatory cytokine levels in the brain were also evaluated, with additional assessment of the role of microglial ablation in reducing TMAO-induced cognitive impairment. Elevated TMAO levels were found to be associated with cognitive decline in mice following femoral fracture surgery, with gut microbiota depletion mitigating both TMAO elevation and cognitive dysfunction. In contrast, fecal microbiota transplantation from postoperative mice resulted in accelerated cognitive dysfunction and TMAO accumulation in germ-free mice. Furthermore, TMAO treatment worsened cognitive deficits, neuroinflammation, and promoted microglial activation, which were reversed through the ablation of microglia. TMAO exacerbates cognitive dysfunction and neuroinflammation in POCD mice, with microglial activation playing a crucial role in this process. Our findings may provide new therapeutic strategies for managing TMAO-related POCD and improving the quality of life for elderly patients.

A Gender-based Study on the Morphometry of Cotyloid Cavity of the Coxal Bone in South Indian Population

Abstract Background and Aim: The cotyloid cavity (acetabulum) is a cup-shaped hollow on the lateral aspect of the coxal bone. The head of the femur articulates with cotyloid cavity to form the hip joint. The cotyloid cavity varies in size, shape, and depth among individuals. Any deviation from the normal range of parameters of the acetabulum may result in arthrosis-related pathologies. Materials and Methods: The present study was conducted on 200 dry human hip bones. The bones were collected from the department of anatomy of a medical college in Mangalore. The following morphometrical parameters of the cotyloid cavity were measured: (a) transverse diameter of acetabulum, (b) acetabular height, (c) acetabular depth, (d) acetabular volume, (e) distance from the pubic tubercle to the anterior rim of the acetabulum, and (f) ratio between distance from the pubic tubercle to the anterior rim of the acetabulum and acetabular height. Range, mean, standard deviation, and standard error of mean were determined for each parameter. P value was also calculated. Gender-wise comparison of the results was done. Results: The independent t-test was done, and the P value was calculated for each parameter. All the parameters showed significant differences between the male and female hip bones. Conclusion: In this modern era, total and partial hip replacement surgeries are very commonly performed. Therefore, knowledge regarding the various morphometrical parameters of the cotyloid cavity may be of great help in the preoperative planning period. It would also be of great help in the fields of forensic anthropology, osteology, and anatomy.

Second opinion machine learning for fast-track pathway assignment in hip and knee replacement surgery: the use of patient-reported outcome measures

BackgroundThe frequency of hip and knee arthroplasty surgeries has been rising steadily in recent decades. This trend is attributed to an aging population, leading to increased demands on healthcare systems. Fast Track (FT) surgical protocols, perioperative procedures designed to expedite patient recovery and early mobilization, have demonstrated efficacy in reducing hospital stays, convalescence periods, and associated costs. However, the criteria for selecting patients for FT procedures have not fully capitalized on the available patient data, including patient-reported outcome measures (PROMs).MethodsOur study focused on developing machine learning (ML) models to support decision making in assigning patients to FT procedures, utilizing data from patients’ self-reported health status. These models are specifically designed to predict the potential health status improvement in patients initially selected for FT. Our approach focused on techniques inspired by the concept of controllable AI. This includes eXplainable AI (XAI), which aims to make the model’s recommendations comprehensible to clinicians, and cautious prediction, a method used to alert clinicians about potential control losses, thereby enhancing the models’ trustworthiness and reliability.ResultsOur models were trained and tested using a dataset comprising 899 records from individual patients admitted to the FT program at IRCCS Ospedale Galeazzi-Sant’Ambrogio. After training and selecting hyper-parameters, the models were assessed using a separate internal test set. The interpretable models demonstrated performance on par or even better than the most effective ‘black-box’ model (Random Forest). These models achieved sensitivity, specificity, and positive predictive value (PPV) exceeding 70%, with an area under the curve (AUC) greater than 80%. The cautious prediction models exhibited enhanced performance while maintaining satisfactory coverage (over 50%). Further, when externally validated on a separate cohort from the same hospital-comprising patients from a subsequent time period-the models showed no pragmatically notable decline in performance.ConclusionsOur results demonstrate the effectiveness of utilizing PROMs as basis to develop ML models for planning assignments to FT procedures. Notably, the application of controllable AI techniques, particularly those based on XAI and cautious prediction, emerges as a promising approach. These techniques provide reliable and interpretable support, essential for informed decision-making in clinical processes.

To further incorporate computer-aided designs to improve preoperative planning in total hip arthroplasty: a cohort study.

Hip replacement surgeries are increasing in demand, requiring rigorous improvements to a mature surgical protocol. Postoperative patient dissatisfaction mainly stems from postoperative complications resulting from the inappropriate selection of prostheses to meet the needs of each patient. This results in prosthesis loosening, hospital-related fractures, and postoperative complex pain, which can all be attributed to inappropriate sizing. In this study, we aimed to further explore the intraoperative and postoperative benefits of incorporating computer-aided design (CAD) in preoperative planning for total hip arthroplasty (THA). A total of 62 patients requiring total hip replacement surgery from January 2021 to December 2021 were collected and randomly divided into a preoperative computer-aided simulated group and a conventional x-ray interpretation group. The accuracy of implant size selection (femoral and acetabular implant) between the preoperative planning and surgical procedure of the two groups was compared. Patient parameters, perioperative Harris hip scores, operative time (skin-to-skin time), surgical blood loss, and postoperative hospital stay were recorded, and the differences between the two groups were statistically compared using a single sample t-test. All patients in the study were successfully operated on and achieved good postoperative functional recovery. With CAD, the selection of the most suitable-sized prosthesis was significantly more accurate compared to the control group (accuracy of the acetabular component between the CAD/control: 80.6%/61.3%, and accuracy of the femoral component: 83.9%/67.7%). Intraoperative blood loss (177.4/231.0 ml, P = 0.002), operation time (84.2 ± 19.8 min/100.3 ± 25.9 min, P = 0.008), duration of hospital stay (6.5 ± 3/9.1 ± 3.9 days, P = 0.003), and postoperative Harris hip score (81.9 ± 6.5/74.7 ± 11.1, P = 0.003) were compared to the control group and showed statistical significance. Incorporating CAD into the preoperative planning of total hip arthroplasty can effectively guide the selection of the most suitable-sized prosthesis, reduce intraoperative blood loss, and promote short-term functional recovery after THA.

1024 Improving Patient Education and Implementation of Early Mobilisation Following Hip or Knee Replacement Surgery

1024 Improving Patient Education and Implementation of Early Mobilisation Following Hip or Knee Replacement Surgery