Have you ever heard of a fast-track program for total hip replacements? That's what my father is on, and we are just wondering what it means.
Patients and surgeons are both interested in a speedy, painless recovery from surgery after a total hip replacement. To reach that goal, surgeons have introduced something called a minimally-invasive surgery (MIS).
Minimally invasive surgery refers to any operation where the surgeon changes how long or how deep the cut is made into the tissue. With some minimally invasive approaches, the surgeon can avoid cutting into most of the muscles around the hip that are normally removed from the bone during the standard hip replacement surgery.
The hope is that with less trauma to the soft tissues (especially the muscles around the hip), the patient will be able to recover that much faster. There are also some efforts to speed up the rehab or postoperative recovery process. A program called the fast-track has been designed to accomplish this.
Several studies have shown that patients who are on the fast-track after surgery get better faster. The fast-track means they get a patient-controlled pump to manage their pain. They start rehab sooner, and the therapist provides a more aggressive program. In studies so far, patients in the fast-track groups are discharged sooner, can walk better, and are more satisfied than patients following the standard rehab protocol. This is true no matter what type of incision or approach was used to do the surgery.
Not everyone can participate in a fast-track program. Patients are selected based on general health, motivation, and compliance level. Complications after surgery such as infection, dislocation, or fracture can put an end to someone's fast-track status. But for those who are able to complete the program, the results have been very impressive.
Simon J. Wall, and Simon C. Mears, MD, PhD. Hip Reconstruction. Minimally Invasive Surgery for Total Hip Arthroplasty. In Current Orthopaedic Practice. January/February 2009. Vol. 20. No. 1. Pp. 25-28.
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