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

This study is not yet open for participant recruitment. (see Contacts and Locations)
Verified May 2013 by Anne Arundel Health System Research Institute
Sponsor:
Collaborator:
DePuy Orthopaedics
Information provided by (Responsible Party):
Anne Arundel Health System Research Institute
ClinicalTrials.gov Identifier:
NCT01857505
First received: May 10, 2013
Last updated: May 17, 2013
Last verified: May 2013
  Purpose

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.


Condition
Total Hip Arthroscopy
Direct Anterior or Posterior Approach
Identical Post Operative Protocol.

Study Type: Observational
Study Design: Observational Model: Case-Only
Time Perspective: Retrospective
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

Resource links provided by NLM:


Further study details as provided by Anne Arundel Health System Research Institute:

Primary Outcome Measures:
  • Length of Hospital Stay [ Time Frame: Retrospective review of hospital discharge records ] [ Designated as safety issue: No ]
    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.

  • Hospital cost [ Time Frame: Retrospective review of utilization records ] [ Designated as safety issue: No ]
    Hospital cost analysis will be undertaken for each group.


Secondary Outcome Measures:
  • Post Operative Pain Medication Utilization [ Time Frame: After retrospective chart review is complete -- approximately 6 months ] [ Designated as safety issue: No ]
    Analysis of post operative pain medicine requirement will be compared for the two groups.

  • Utilization of inpatient physical therapy resources [ Time Frame: Retrospective review -- of hospital discharge ] [ Designated as safety issue: No ]
    Utilization of inpatient physical therapy resources and post hospital discharge disposition will be compared for the two groups.


Estimated Enrollment: 210
Study Start Date: May 2013
Estimated Primary Completion Date: December 2013 (Final data collection date for primary outcome measure)
Groups/Cohorts
Direct Anterior Approach hip replacement
Single surgeon series of 105 consecutive patients who underwent hip replacement via the direct anterior approach on a fracture table
Posterior Approach Hip Replacement
105 consecutive patients previously operated on by a less invasive posterior approach at the same institution. These surgeries occurred prior to March, 2010.

Detailed 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.

  Eligibility

Ages Eligible for Study:   40 Years to 90 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Patients who have undergone primary uncemented hip replacement at our institution (Anne Arundel Medical Center) through either a posterior approach or direct anterior approach on a fracture table utilizing the identical post operative protocol.

Criteria

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.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01857505

Contacts
Contact: Candy Costantini 443-481-1343 dcostantin@aahs.org
Contact: Andrea Stone, CRNP 800-331-2466 astone@aahs.org

Locations
United States, Maryland
Anne Arundel Medical Center Not yet recruiting
Annapolis, Maryland, United States, 21401
Principal Investigator: Paul King, M.D.         
Sponsors and Collaborators
Anne Arundel Health System Research Institute
DePuy Orthopaedics
Investigators
Principal Investigator: Paul King, M.D. Anne Arundel Medical Center / Anne Arundel Orthopedic Surgeons
  More Information