Dislocation, Hip, PROM, THA
Conditions
Brief summary
The purpose of this study is to design a fast-track pathway for patients referred to the University Hospital of Southern Denmark, Esbjerg, with high probability of having a dislocated hip prosthesis with the primary aim to reduce the time from arrival to reduction and the total hospitalization time. Secondary aims are to * investigate whether quicker prosthesis reduction influences on hip function and quality of life afterwards * reduce the pain experience immediately and in the long term * increase patient satisfaction without changing the overall complication rate and readmission/mortality
Interventions
OTHERFasttrack pathway for THA/HE prosthesis reduction
The purpose of this study is to design a fast-track pathway for patients referred to the University Hospital of Southern Denmark, Esbjerg, with high probability of having a dislocated hip prosthesis with the primary aim to reduce the time from arrival to reduction and the total hospitalization time. The intervention is changed logistic and work pathways at the hospital that should reduce time to reduction significantly. For detailed description we refer to the uploaded protocol.
OTHERStandard pathway for THA/HE prosthesis reduction
Standard treatment for a dislocated THA/HA at our institution is education in general anesthesia at the operating theater. For detailed description we refer to the uploaded protocol.
Sponsors
University Hospital of Southern Denmark
University of Southern Denmark
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* a history of either a THA or a HA in combination with at least one of the following terms * having sustained a sudden, incorrect movement or twist in the hip joint in either a bending, sitting or supine position leading to inability to stand or walk * misalignment of the concerned lower extremity (typically shortened, with inward/outward rotation)
Exclusion criteria
* recurrent dislocations during the same hospital admission (already in the house) * anticipated difficult airway by the attending anesthesiologist * anticipated need for extended respiratory or hemodynamic monitoring by the attending anesthesiologist * American Society of Anesthesiologists (ASA) score \> 3 * Body Mass Index (BMI) \> 40 * active drug abuse * contraindication for Propofol or Esketamine
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time from arrival at the emergency entrance to prosthesis reduction | 1 year |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intra-operative complications (fracture, unsuccessful reduction, aspiration, need for mask ventilation and/or intubation, others) | 1 year | — |
| Post-operative complications (cardiac, pulmonal, thrombo-embolic events, nerve damage, re-dislocation, others) during hospitalization | 1 year | — |
| 30 days re-admission | 30 days | — |
| 30- and 90-days mortality | 30 and 90 days | — |
| Hip-related pain measured by a 10-digit numeric rating scale (NRS) | Day 0, 1, 3, 7, 14 and 30 | Evaluated from 1 (best) to 10 (worst). |
| Total hospitalization time from arrival to discharge | 1 year | — |
| Health-related quality of life using the EQ-5D questionnaire | Day 0, 14, 90, 180 and 365 | — |
| Patient satisfaction | During hospital admission, day 1. | Consists of four self-developed questions. |
| Time consumption by the involved staff (orthopedic, anesthetic, radiology staff etc.) | 1 year | — |
| Total hospital costs during admission | 1 year | — |
| Patient-reported outcome (PRO) using the Hip disability and Osteoarthritis Outcome Score (HOOS), | Day 0, 14, 90, 180 and 365 | Evaluated from 0 (worst) to 100 (best). |
Outcome results
None listed