Hip Replacement in a High Volume Community Hospital: Effect on Length of Stay and Hospital Cost

Hip Osteoarthritis Clinical Trial

Official title:

Introduction of the Direct Anterior Approach to Hip Replacement Into a High Volume Community Hospital: Effect on Length of Stay and Hospital Cost

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT01857505
• Other study ID #: IIS-000158
• Status: Withdrawn
• Phase: N/A
• First received: May 10, 2013
• Last updated: December 17, 2014

Study information

• Verified date: December 2014
• Source: Anne Arundel Health System Research Institute
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Observational

Clinical Trial Summary

The investigators propose to evaluate and compare the percentage of patients who are able to be discharged in less than 3 days after undergoing total hip arthroscopy through either a direct anterior or posterior approach, utilizing the identical post operative protocol. The investigators also propose to evaluate the costs associated with the two different approaches to hip replacement in the same group of patients. Post operative resource utilization, discharge disposition, and pain medicine requirement will also be evaluated.

Description:

The investigators hypothesize that a higher proportion of patients treated with the direct anterior approach for hip replacement will be able to leave the hospital in less than 3 days when compared with a less invasive posterior approach. Secondly, decreased length of stay associated with the procedure may reduce hospital costs.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. primary completion date: January 2014
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 40 Years to 90 Years

Eligibility

Inclusion Criteria:

1. Consecutive single surgeon series of patients who have undergone primary uncemented hip replacement at our institution through either a posterior approach or direct anterior approach on a fracture table. Posterior approach patient - most recent patient prior to March, 2010, compared with consecutive recent anterior approach patients with minimum of 6 month follow-up.

2. Diagnosis of osteoarthritis, inflammatory arthritis, or avascular necrosis.

3. No previous surgery on affected hip.

4. Age 40-90 at time of surgery

Exclusion Criteria:

1. Patient not permitted to bear full weight after the procedure, per post operative instructions

2. Hip replacement performed for acute fracture.

3. Previous hip surgery.

Study Design

Observational Model: Case-Only, Time Perspective: Retrospective

Related Conditions & MeSH terms

• Hip Osteoarthritis
• Osteoarthritis, Hip

Locations

Country	Name	City	State
United States	Anne Arundel Medical Center	Annapolis	Maryland

Sponsors (2)

Lead Sponsor	Collaborator
Anne Arundel Health System Research Institute	DePuy Orthopaedics

Country where clinical trial is conducted

United States, 

References & Publications (5)

Duwelius PJ, Moller HS, Burkhart RL, Waller F, Wu Y, Grunkemeier GL. The economic impact of minimally invasive total hip arthroplasty. J Arthroplasty. 2011 Sep;26(6):883-5. doi: 10.1016/j.arth.2010.09.011. Epub 2010 Nov 3. — View Citation

Hayes JH, Cleary R, Gillespie WJ, Pinder IM, Sher JL. Are clinical and patient assessed outcomes affected by reducing length of hospital stay for total hip arthroplasty? J Arthroplasty. 2000 Jun;15(4):448-52. — View Citation

Matta JM, Ferguson TA. The anterior approach for hip replacement. Orthopedics. 2005 Sep;28(9):927-8. — View Citation

Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res. 2005 Dec;441:115-24. — View Citation

Vorhies JS, Wang Y, Herndon J, Maloney WJ, Huddleston JI. Readmission and length of stay after total hip arthroplasty in a national Medicare sample. J Arthroplasty. 2011 Sep;26(6 Suppl):119-23. doi: 10.1016/j.arth.2011.04.036. Epub 2011 Jul 1. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Length of Hospital Stay	The length of stay and proportion of patients who went home in less than 3 days will be determined for each group. To evaluate and compare the percentage of patients who are able to be discharged in less than 3 days after undergoing total hip arthroscopy through either a direct anterior or posterior approach, utilizing the identical post operative protocol.	Retrospective review of hospital discharge records	No
Primary	Hospital cost	Hospital cost analysis will be undertaken for each group.	Retrospective review of utilization records	No
Secondary	Post Operative Pain Medication Utilization	Analysis of post operative pain medicine requirement will be compared for the two groups.	After retrospective chart review is complete -- approximately 6 months	No
Secondary	Utilization of inpatient physical therapy resources	Utilization of inpatient physical therapy resources and post hospital discharge disposition will be compared for the two groups.	Retrospective review -- of hospital discharge	No