Improved early recovery and shorter hospital stay with fast track protocol versus standard care in total hip arthroplasty: 5‐year results from a prospective randomised controlled study
Why this work is in the frame
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Bibliographic record
Abstract
Abstract Purpose Total hip arthroplasty (THA) is a widely performed surgery with growing demand globally. This study aims to evaluate the effectiveness of a fast track (FT) protocol compared to standard care (SC) in patients undergoing THA. Methods Ninety patients aged 18–70 years with primary unilateral hip osteoarthritis, American Society of Anesthesiologists (ASA) score <3, body mass index (BMI) ≤ 32 and no cognitive or psychiatric disorders were prospectively enrolled from March 2018 to January 2020. All patients provided informed consent and were randomised to the FT or SC groups. The FT protocol consisted of preoperative education, oral analgesic pain management and early intensive rehabilitation. Functional autonomy was assessed on postoperative Day 3 using the Iowa Level of Assistance (ILOA) scale. Follow‐up assessments at 6 weeks, 3, 6, 12 and 60 months included the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results Forty‐six patients were assigned to the FT group. Both groups were comparable in baseline demographics. The FT group showed significantly faster early functional recovery, with lower ILOA scores on postoperative Day 3 (9.60 ± 5.2 vs. 11.7 ± 3.4; p = 0.024), and a shorter hospital stay (3.54 ± 1.25 vs. 6.39 ± 1.59 days; p < 0.0001). WOMAC scores were significantly better in the FT group at 6 weeks (10.38 ± 9.18 vs. 14.21 ± 8.76; p = 0.035) and remained superior at 60 months (0 ± 0 vs. 0.27 ± 0.81; p = 0.027). Although baseline HHS was higher in the FT group, greater improvements from baseline were seen in the SC group at later follow‐ups, likely due to a ceiling effect. Conclusions The FT protocol enhances early postoperative recovery and significantly reduces hospital stay after THA without compromising safety. Long‐term functional outcomes favour the FT approach, supporting its implementation to improve recovery in appropriately selected patients undergoing hip arthroplasty. Level of Evidence Level II.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it