Same-Day Versus Next-Day Discharge Increased Pain on the Day After, But Not on the Day of or Four Weeks After, Total Hip Arthroplasty

Abstract

Goyal N, Chen AF, Padgett SE, Tan TL, Kheir MM, Hopper RH Jr, Hamilton WG, Hozack WJ. Otto Aufranc Award: a multicenter, randomized study of outpatient versus inpatient total hip arthroplasty. Clin Orthop Relat Res. 2016 Jun 10. [Epub ahead of print]. ### Question: In patients having total hip arthroplasty, does planned discharge on the same day versus the next day lead to different outcomes in terms of postoperative pain, complications, and health-care provider visits? ### Design: Randomized (allocation concealed)*, unblinded, controlled trial with 4 weeks of follow-up and intention-to-treat analysis. ClinicalTrials.gov NCT02230657. ### Setting: 2 high-volume, adult reconstruction centers in the United States. ### Patients: 220 patients <75 years of age (mean age, 60 years; 53% men) with a body mass index of <40 kg/m2 who underwent primary unilateral total hip arthroplasty through a direct anterior approach. The exclusion criteria included chronic opioid use, need for a walker or wheelchair, lack of assistance at home, or history of cardiopulmonary disease with need for acute inpatient monitoring. 100% of patients completed follow-up. ### Intervention: Planned …