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门诊全髋关节置换术的结局:一项系统评价。

Outcomes of outpatient total hip arthroplasty: a systematic review.

机构信息

American Hip Institute Research Foundation, Des Plaines, IL, USA.

Sidney Kimmel Medical College, Philadelphia, PA, USA.

出版信息

Hip Int. 2021 Jan;31(1):4-11. doi: 10.1177/1120700020911639. Epub 2020 Mar 11.

Abstract

INTRODUCTION

Similar to other total joint arthroplasty procedures, total hip arthroplasty (THA) is shifting to an outpatient setting. The purpose of this study was to analyse outcomes following outpatient THA.

METHODS

A comprehensive literature search was performed in April 2019 according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines using the PubMed, Embase, and Cochrane databases to identify articles that reported functional outcomes following outpatient total hip arthroplasty (THA).

RESULTS

9 articles, with 683 hips and a collective study period of 1988 to 2016, were included in this analysis. The mean age across all studies was 58.9 years and the follow-up period ranged from 4 weeks to 10 years. 4 studies reported Harris Hip Scores (HHSs) for their patient populations and in 3 studies, the average HHSs were excellent (>90) by 6 weeks postoperatively. The fourth study reported fair HHS scores for the outpatient and inpatient THA groups (75 ± 18, 75 ± 14, 0.77, respectively) at 4 weeks postoperatively. VAS scores improved significantly in two studies and NRS at rest and during activity improved significantly ( 0.001) in a separate study. Overall, 88.1% of the enrolled patients were discharged the same day of surgery, as expected. Out of the 6 studies reporting on readmissions rate, there were two (0.34%) readmissions within 3 months of surgery.

CONCLUSION

In patients with no significant comorbidities, outpatient THA leads to favourable outcomes as well as low readmission rates in the short term.

摘要

简介

与其他全关节置换术类似,全髋关节置换术(THA)正逐渐转为门诊手术。本研究旨在分析门诊 THA 的术后结果。

方法

根据 PRISMA(系统评价和荟萃分析的首选报告项目)指南,于 2019 年 4 月在 PubMed、Embase 和 Cochrane 数据库中进行了全面的文献检索,以确定报告门诊全髋关节置换术(THA)术后功能结果的文章。

结果

共纳入 9 项研究,683 髋,研究期间为 1988 年至 2016 年。所有研究的平均年龄为 58.9 岁,随访时间从 4 周到 10 年不等。4 项研究报告了患者人群的 Harris 髋关节评分(HHS),其中 3 项研究在术后 6 周时平均 HHS 为优秀(>90)。第 4 项研究报告门诊和住院 THA 组的 HHS 分别为 4 周时(75±18、75±14,0.77)。两项研究的 VAS 评分显著改善,另一项研究的 NRS 休息和活动时评分显著改善(0.001)。总体而言,预计 88.1%的患者在手术当天出院。在报告再入院率的 6 项研究中,有 2 项(0.34%)在术后 3 个月内再入院。

结论

在没有明显合并症的患者中,门诊 THA 可获得良好的结果,且短期内再入院率较低。

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