Early mobilization after total hip or knee arthroplasty: a substudy of the POWER.2 study.

Brazilian Journal of Anesthesiology
Javier Ripollés-MelchorPOWER2 Study Investigators Group for the Spanish Perioperative Audit and Research Network (RedGERM-SPARN)

Abstract

Early mobilization after surgery is a cornerstone of the Enhanced Recovery After Surgery (ERAS) programs in total hip arthroplasty (THA) or total knee arthroplasty (TKA). Our goal was to determine the time to mobilization after this surgery and the factors associated with early mobilization. This was a predefined substudy of the POWER.2 study, a prospective cohort study conducted in patients undergoing THA and TKA at 131 Spanish hospitals. The primary outcome was the time until mobilization after surgery as well as determining those perioperative factors associated with early mobilization after surgery. A total of 6093 patients were included. The median time to achieve mobilization after the end of the surgery was 24 hours [16-30]. 4,222 (69.3%) patients moved in ≤ 24 hours after surgery. Local anesthesia [OR = 0.80 (95% confidence interval [CI]: 0.72-0.90); p = 0.001], surgery performed in a self-declared ERAS center [OR = 0.57 (95% CI: 0.55-0.60); p < 0.001], mean adherence to ERAS items [OR = 0.93 (95% CI: 0.92-0.93); p < 0.001], and preoperative hemoglobin [OR = 0.97 (95% CI: 0.96-0.98); p < 0.001] were associated with shorter time to mobilization. Most THA and TKA patients mobilize in the first postoperative day, early tim...Continue Reading

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