Niveles de dolor y satisfacción en pacientes sometidos a reemplazo total de cadera bilateral en dos tiempos quirúrgicos (manejo ambulatorio e intrahospitalario)

Oscar Andrés Ramírez-Guerrero; Jorge Eduardo Manrique-González; Andrés Restrepo-Uribe; Jorge de Francisco Casas-Galindo; Sofia Elizabeth Muñoz-Medina; Jairo Alonso Rincón-Hoyo

doi:10.58814/01208845.43

Authors

Oscar Andrés Ramírez-Guerrero Fundación Universitaria Sanitas, Faculty of Medicine, Bogotá D.C., Colombia. https://orcid.org/0000-0003-4447-602X
Jorge Eduardo Manrique-González Grupo Empresarial Keralty, Clínica Universitaria Colombia, Orthopedics Service, Joint Replacement Group, Bogotá D.C., Colombia. https://orcid.org/0000-0002-0021-4450
Andrés Restrepo-Uribe Grupo Empresarial Keralty, Clínica Universitaria Colombia, Orthopedics Service, Joint Replacement Group, Bogotá D.C., Colombia. https://orcid.org/0000-0002-2157-5634
Jorge de Francisco Casas-Galindo Grupo Empresarial Keralty, Clínica Universitaria Colombia, Orthopedics Service, Joint Replacement Group, Bogotá D.C., Colombia. https://orcid.org/0000-0002-2291-2823
Sofia Elizabeth Muñoz-Medina Fundación Universitaria Sanitas, Research Unit, Bogotá D.C., Colombia. https://orcid.org/0000-0002-8038-298X
Jairo Alonso Rincón-Hoyo Grupo Empresarial Keralty, Clínica Universitaria Colombia, Orthopedics Service, Joint Replacement Group, Bogotá D.C., Colombia.

DOI:

https://doi.org/10.58814/01208845.43

Keywords:

Arthroplasty, Replacement, Hip, Outpatient care, Hospital Care, Pain, Patient Satisfaction

Abstract

Introduction: With the improvement of surgical techniques for hip prosthesis implantation, advances in analgesia and the standardization of postoperative protocols, together with early rehabilitation, the length of hospital stay has decreased and the performance of outpatient total hip replacements (THR) has become more common.

Objective: To determine the levels of postoperative pain and satisfaction among patients undergoing two-stage bilateral total hip arthroplasty (stage 1: outpatient management; stage 2: inpatient management), and to make an exploratory comparison of these levels between both stages.

Methodology: Descriptive observational study conducted in 52 patients who underwent bilateral THR in two stages at two quaternary care hospitals in Bogotá D.C. (Colombia) between January 2013 and November 2022. Postoperative pain was assessed using the visual analog scale (VAS) and satisfaction with the procedure was assessed using the validated self-administered patient satisfaction scale (SAPS).

Results: Patients’ median age was 64.5 years and 65.38% were women. The median VAS score was 5.35 and 5.73 at the first and second stage, respectively (p=0.52). Moreover, the median overall SAPS score at both stages was 93.7 (p=0.91). A higher frequency of emergency revisits (1.92% vs. 9.62%; p=0.02) and adverse events (0 vs. 1.92%; p=0.84) were observed in the second stage.

Conclusions: Satisfaction with the procedure was similar at both surgical stages. The level of pain was higher in the second stage, without the difference being statistically significant.

Downloads

Download data is not yet available.

References

Aynardi M, Post Z, Ong A, Orozco F, Sukin DC. Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study. HSS J. 2014;10(3):252-5. https://doi.org/mbp9.

Sivaloganathan S, Blakeney WG, Vendittoli PA. Modernizing Total Hip Arthroplasty Perioperative Pathways: The Implementation of ERAS-Outpatient Protocol. J Clin Med. 2022;11(12):3293. https://doi.org/mbqb.

Bashinskaya B, Zimmerman RM, Walcott BP, Antoci V. Arthroplasty Utilization in the United States is Predicted by Age-Specific Population Groups. ISRN Orthop. 2012;2012:185938. https://doi.org/gb7qpb.

Sayeed Z, Abaab L, El-Othmani M, Pallekonda V, Mihalko W, Saleh KJ. Total Hip Arthroplasty in the Outpatient Setting: What You Need to Know (Part 1). Orthop Clin North Am. 2018;49(1):17-25. https://doi.org/gcrzbv.

Register JL, Head PJ, Orteneau G. Establishing a successful outpatient joint arthroplasty program. AORN J. 2018;108(1):44-50. doi: 10.1002/aorn.12277. https://doi.org/gd2cng.

Banerjee S, Hamilton WG, Khanuja HS, Roberts JT. Outpatient lower extremity total joint arthroplasty: Where are we heading? Orthopedics. 2017;40(2):72-5. https://doi.org/gsjkb2.

Anger M, Valovska T, Beloeil H, Lirk P, Joshi GP, Van de Velde M, et al. PROSPECT guideline for total hip arthroplasty: a systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 2021;76(8):1082-97. https://doi.org/gj45x8.

Abdallah FW, McCartney CJL. Recommendations for total hip arthroplasty pain management: what's old, what's new and what continues to be missing? Anesthesia. 2021;76(8):1018-20. https://doi.org/gj45x8.

Lovett-Carter D, Sayeed Z, Abaab L, Pallekonda V, Mihalko W, Saleh KJ. Impact of Outpatient Total Joint Replacement on Postoperative Outcomes. Orthop Clin North Am. 2018;49(1):35-44. https://doi.org/gcrxcn.

Toy PC, Fournier MN, Throckmorton TW, Mihalko WM. Low Rates of Adverse Events Following Ambulatory Outpatient Total Hip Arthroplasty at a Free-Standing Surgery Center. J Arthroplasty. 2018;33(1):46-50. https://doi.org/gcsnpr.

Rosinsky PJ, Chen SL, Yelton MJ, Lall Ajay C, Maldonado DR, Shapira J, et al. Outpatient vs. inpatient hip arthroplasty: a matched case-control study on a 90-day complication rate and 2-year patient-reported outcomes. J Orthop Surg Res. 2020;15(1):367. https://doi.org/gsjkfn.

Shapira J, Chen SL, Rosinsky PJ, Maldonado DR, Lall AC, Domb BG. Outcomes of outpatient total hip arthroplasty: a systematic review. Hip Int. 2021;31(1):4-11. https://doi.org/gsjkbr.

Bemelmans YFL, Keulen MHF, Heymans M, van Haaren EH, Boonen B, Schotanus MGM. Safety and efficacy of outpatient hip and knee arthroplasty: a systematic review with meta-analysis. Arch Orthop Trauma Surg. 2022;142(8):1775-91. https://doi.org/gh6m8b.

Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780-5. https://doi.org/db66gz.

Specht K, Kjaersgaard-Andersen P, Pedersen BD. Patient experience in fast-track hip and knee arthroplasty - a qualitative study. J Clin Nurs. 2016;25(5-6):836-45. https://doi.org/mbqd.

Bordoni V, Marelli N, Previtali D, Gaffurini P, Filardo G, Candrian C. Outpatient total hip arthroplasty does not increase complications and readmissions: a meta-analysis. Hip Int. 2022;32(3):326-33. https://doi.org/gsjkb7.

Stangl Correa WP. Validación de la escala de satisfacción del paciente autodiligenciada (SAPS) para artroplastia primaria de rodilla y cadera [Thesis]. Bogotá: Universidad del Rosario;2018. 41p. https://doi.org/mbqf.

Mahomed N, Gandhi R, Daltroy L, Katz JN. The Self-Administered Patient Satisfaction Scale for Primary Hip and Knee Arthroplasty. Arthritis. 2011;2011: 591253. https://doi.org/bfth7t.

World Medical Association (WMA). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. Fortaleza: 64th WMA General Assembly; 2013.

Colombia. Ministerio de Salud. Resolución 8430 de 1993 (octubre 4): Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá D.C.; octubre 4 de 1993 [cited 2024 Feb 08]. Available from: https://bit.ly/31gu7do.

Goyal N, Chen AF, Padgett SE, Tan TL, Kheir MM, Hopper RH, et al. Otto Aufranc Award: A Multicenter, Randomized Study of Outpatient versus Inpatient Total Hip Arthroplasty. Clin Orthop Relat Res. 2017;475(2):364-72. https://doi.org/gk4w2m.

Pollock M, Somerville L, Firth A, Lanting B. Outpatient total hip arthroplasty, total knee arthroplasty, and unicompartmental knee arthroplasty: A systematic review of the literature. JBJS Rev. 2016;4(12):e4. https://doi.org/f9kgxh.

Meneghini RM, Ziemba-Davis M. Patient Perceptions Regarding Outpatient Hip and Knee Arthroplasties. J Arthroplasty. 2017;32(9):2701-2705.e1. https://doi.org/gbv6gk.