Table 3.

Future perspectives in ‘fast-track’ total hip arthroplasty (THA) surgery research

• THA surgery as an outpatient procedure: Studies with careful estimations of cost-effectiveness of THA outpatient procedures are needed and surgeons wishing to implement outpatient total joint arthroplasty clinical pathways must focus on preventing post-discharge medical complications and include blood management strategies

• Lack of evidence of the effect of post-operative physiotherapy in THA patients as a group: Further studies are needed to identify patients with individual needs for training and rehabilitation after THA surgery especially in patients with co-morbidity or advanced age

• A rise in elderly frail patients and patients with severe co-morbidity receiving a THA: This group of patients also have a potential benefit of fast-track surgery and future studies should focus on introducing fast-track patient paths and reducing morbidity plus mortality in elderly frail patients and patients with severe co-morbidity receiving a THA

• Increased risk of complications and re-admission in patients with psychiatric diseases: Further studies aimed at a more thorough and individualised pre-operative evaluation in psychiatric patients receiving a THA are needed to optimise a fast-track patient pathway for this high-risk patient group

• Individualised fast-track strategies: Fast-track THA surgery works extremely well in the standard THA patient. Patients are, however, different and future studies should focus on fine-tuning the multiple areas in fast-track pathways to get patients with special needs or a high co-morbidity burden through a safe and effective fast-track THA pathway