1–year follow–up of 920 hip and knee arthroplasty patients after implementing fast–track: Good outcomes in a Norwegian university hospital

BACKGROUND: Fast–track has become a well–known concept resulting in improved patient satisfaction and postoperative results. Concerns have been raised about whether increased efficiency could compromise safety, and whether early hospital discharge might result in an increased number of complications. We present 1–year follow–up results after implementing fast–track in a Norwegian university hospital. METHODS: This was a register–based study of 1,069 consecutive fast–track hip and knee arthroplasty patients who were operated on between September 2010 and December 2012. Patients were followed up until 1 year after surgery. RESULTS: 987 primary and 82 revision hip or knee arthroplasty patients were included. 869 primary and 51 revision hip or knee patients attended 1–year follow–up. Mean patient satisfaction was 9.3 out of a maximum of 10. Mean length of stay was 3.1 days for primary patients. It was 4.2 days in the revision hip patients and 3.9 in the revision knee patients. Revision rates until 1–year follow–up were 2.9% and 3.3% for primary hip and knee patients, and 3.7% and 7.1% for revision hip and knee patients. Function scores and patient–reported outcome scores were improved in all groups. INTERPRETATION: We found reduced length of stay, a high level of patient satisfaction, and low revision rates, together with improved health–related quality of life and functionality, when we introduced fast–track into an orthopedic department in a Norwegian university hospital.