Hip replacement: minimally invasive techniques and faster recovery with the Fast Track protocol taking place at Città Di Pavia Hospital

September 22, 2020

Città Di Pavia Hospital part of San Donato Hospital Group proposes a protocol of hip replacement surgery that aims to reduce invasiveness and ‘discomfort’.

In fact as explained by Dr Emanuele Caldarella, Head of the Operational Unit of Orthopedic Minimal invasive Surgery “You cannot and should not identify the ‘mini invasiveness’ with the small size of the cut. From a surgical point of view, it is crucial to adopt tissue saving methods that reduce the actual invasiveness of the procedure, regardless of the size of the cut.

Thanks to our long years of experience in these surgeries and our continuous engagement in research on the application of minimally invasive techniques in the prosthetic field – continues the specialist – has led us to develop a so-called ‘FAST TRACK’ protocol  that aims to reduce every element of possible invasiveness and ‘discomfort’ towards the patient, while reducing the so-called ‘disease perception’ linked to hospitalization and surgical pathway.”

 This protocol can also be adapted to each patient based on their needs and general conditions. A very fragile and elderly patient, could benefit greatly from minimally invasive anesthesiology techniques but perhaps he will not be eligible for a discharge to his home just 72 hours after surgery. In this case, a longer rehabilitation admission will be recommended.”

The advantages of the protocol

The objectives of this FAST TRACK protocol are:

  1. RE REDUCTION of the timeframe for preparation for the intervention, concentrating all the investigations in a single half-day of pre-operation;
  2. Avoiding the bladder catheter and enema, thanks to advanced anesthesiology techniques;
  3. REDUCTION of surgical time, thanks to the use of computer tools for preoperative planning;
  4. USE of tissue-saving surgical techniques, functional and anatomical (so-called “minimally invasive” techniques);
  5. AVOID the blood donor transfusions, and the use of drainage through dedicated surgical and anesthesiology techniques (femur first in the hip, reduction of surgical time, use of tranexamic acid);
  6. REDUCTION of postoperative pain through the use of postoperative locoregional anesthesia methods;
  7. IMMEDIATE MOBILIZATION of the patient, who can walk on the same day of surgery, reducing to a few hours the post-operative immobilization in bed.
  8. AVOID elastic stockings, heparin injections and skin points in favor of oral pharmacological approaches and sutures based on medical glues that do not require removal;
  9. REDUCTION of hospitalization time, making the patient eligible for discharge already 72 hours after surgery (3 nights of hospitalization);
  10. SIMULTANEOUSLY BILATERAL PROCEDURES WHEN indicated.

These results, unthinkable by applying the classic protocols of hospitalization, are possible thanks to the widespread organization of work, the appropriate information and training of the patient and the rigorous application of the appropriate surgical, rehabilitative and anesthesiology techniques”.

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