Daytime hip arthroplasty refers to a medical procedure where a patient undergoes admission, surgery, and discharge all within a single day (24 hours). The establishment of daytime hip arthroplasty centers signifies a significant paradigm shift in the development model of modern hospitals. While numerous nationally accredited large medical institutions are undertaking daytime hip arthroplasty in various forms and scales, there remains a lack of standardized system processes and criteria. In this context, the National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Bone and Joint Specialty Committee of the China Ambulatory Surgery Alliance, Joint Surgery Branch of the Chinese Orthopedic Association, and Osteoarthritis Study Group of the Chinese Association of Orthopedic Surgeons have collaboratively organized experts in the relevant field domestically. Leveraging international experiences in daytime hip arthroplasty and integrating them with the clinical practices of well-established medical institutions conducting daytime surgeries in China, they have arrived at consensus recommendations. These recommendations cover the establishment of daytime hip arthroplasty centers, policies, procedures, and perioperative management. The ultimate goal is to provide reference points and guidance for the standardized implementation of daytime hip arthroplasty.
日间髋关节置换手术是指接受髋关节置换手术患者在1 d（24 h）内完成入院、手术和出院的医疗模式。设置日间髋关节置换手术中心是适应现代医院发展模式的重大转变。全国已有部分大型医院以不同形式和规模开展了日间髋关节置换手术，但尚缺乏统一的制度规范和流程。在此背景下，国家老年疾病临床医学研究中心（湘雅医院）、中国日间手术合作联盟骨关节专业委员会、中华医学会骨科学分会关节外科学组和中国医师协会骨科医师分会骨关节炎学组联合组织国内相关领域专家，借鉴国际日间髋关节置换手术经验，结合国内开展日间手术的临床实践，从日间髋关节置换手术中心的设置、制度、流程以及围术期管理达成共识，旨在为规范化开展日间髋关节置换手术提供参考和指导。.

Institutional arthroplasty registries are very popular nowadays; however, very few efforts have been made in order to standardize the information to be collected, thus limiting the possibility of inter-institutional data interpretation. This manuscript reports the results of a single-country consensus designed to define the minimum standardized dataset to be recorded within an institutional arthroplasty registry.
A national consensus was carried out among all members of the Colombian Society of Hip and Knee Surgeons using the Delphi method. Eleven questions and answers comprising every potential domain of an institutional registry of hip and knee arthroplasty were defined. According to the methodology, anonymous voting and multiple discussion rounds were performed. Three levels of agreement were defined: Strong consensus: equal to or greater than 80%, weak consensus between 70 and 79.9%, and no consensus below 70%.
All of the questions reached consensus level. The minimum dataset was defined to include demographic and clinical information, intraoperative and implant details, follow-up and early complications, implant survival, and functional outcome scores, as well as the validation model to assess information quality within the database. Currently, this dataset is being implemented voluntarily by the members of our national society.
A national consensus is a feasible method to build homogeneous arthroplasty registries. We recommend such an exercise since it establishes the basis to compare and add data between institutions and the joint analysis of said information in a national registry.

Hip and knee arthroplasties have revolutionised the management of degenerative joint diseases and, due to an ageing population, are becoming increasingly common. Follow-up of joint prostheses is to identify problems in symptomatic or asymptomatic patients due to infection, osteolysis, bone loss or potential periprosthetic fracture, enabling timely intervention to prevent catastrophic failure at a later date. Early revision is usually more straight-forward surgically and less traumatic for the patient. However, routine long-term follow-up is costly and requires considerable clinical time. Therefore, some centres in the UK have curtailed this aspect of primary hip and knee arthroplasty services, doing so without an evidence base that such disinvestment is clinically or cost-effective.
Given the timeline from joint replacement to revision, conducting a randomised controlled trial (RCT) to determine potential consequences of disinvestment in hip and knee arthroplasty follow-up is not feasible. Furthermore, the low revision rates of modern prostheses, less than 10% at 10 years, would necessitate thousands of patients to adequately power such a study. The huge variation in follow-up practice across the UK also limits the generalisability of an RCT. This study will therefore use a mixed-methods approach to examine the requirements for arthroplasty follow-up and produce evidence-based and consensus-based recommendations as to how, when and on whom follow-up should be conducted. Four interconnected work packages will be completed: (1) a systematic literature review; (2a) analysis of routinely collected National Health Service data from five national data sets to understand when and which patients present for revision surgery; (2b) prospective data regarding how patients currently present for revision surgery; (3) economic modelling to simulate long-term costs and quality-adjusted life years associated with different follow-up care models and (4) a Delphi-consensus process, involving all stakeholders, to develop a policy document which includes a stratification algorithm to determine appropriate follow-up care for an individual patient.
Favourable ethical opinion has been obtained for WP2a (RO-HES) (220520) and WP2B (220316) from the National Research Ethics Committee. Following advice from the Confidentiality Advisory Group (17/CAG/0122), data controllers for the data sets used in WP2a (RO-HES) - NHS Digital and The Phoenix Partnership - confirmed that Section 251 support was not required as no identifiable data was flowing into or out of these parties. Application for approval of WP2a (RO-HES) from the Independent Group Advising on the Release of Data (IGARD) at NHS Digital is in progress (DARS-NIC-147997). Section 251 support (17/CAG/0030) and NHS Digital approval (DARS-NIC-172121-G0Z1H-v0.11) have been obtained for WP2a (NJR-HES-PROMS). ISAC (11_050MnA2R2) approval has been obtained for WP2a (CPRD-HES).

The aim of this retrospective audit was to determine the route of referral or presentation of patients requiring revision following primary total hip arthroplasty (THA).
A total of 4802 patients were implanted with an Orthopaedic Data Evaluation Panel (ODEP) 10A* cementless implant (Corail/Pinnacle) between 2005 and 2015; 80 patients with a mean age of 67.8 years (sd 10.8) underwent a subsequent revision. The primary outcome measure was route of referral for revision.
Of the 80 revisions, 31 (38.8%) took place within the first year and 69 (86.3%) took place within six years. Only two of the 80 patients were picked up at a routine review clinic, one for infection and the other for liner dissociation. A total of 36 revised patients (45.0%) were reviewed following self-referral. Of the remaining 44 revised patients (55.0%), 15 (18.8%) were General Practitioner referrals, 13 (16.3%) were other hospital referrals, six (7.5%) were inpatients, six (7.5%) were Emergency Department referrals, and two (2.5%) were readmitted from their homes. No revisions were carried out on asymptomatic patients.
Our experience suggests that if there is a robust system in place for self-referral, patients with an ODEP 10A* hip implant can, if asymptomatic, be safely discharged at the time of their first postoperative review. Cite this article: Bone Joint J 2019;101-B:536-539.

OBJECTIVE: To measure adherence to a nurse-led evidence-based venous thromboembolism prevention programme (intervention) compared to usual care in hip and knee arthroplasty patients and associated clinical outcomes.
BACKGROUND: Venous thromboembolism morbidity and mortality of hospitalised patients is a major concern for health professionals. Venous thromboembolism prevention guidelines have been developed; however, adherence to guidelines is variable.
METHODS: There were 410 potential participants who were adult patients that were booked for elective hip or knee arthroplasty at the two study sites during a 2-year period (2011-2013). Of these, 27 did not meet the inclusion criteria, and the remainder were eligible for inclusion in the study (intervention site n = 196 and control site n = 187, total population n = 383).
METHODS: This study adopted a quasi-experimental design, using an intervention and control study site, conducted in two private hospitals in a regional area in Australia.
RESULTS: The intervention group had a mean compliance score of 11.09, higher than the control group score of 7.19. This is equivalent to a compliance rate of 85% and 55%, respectively, and indicates that adherence at the study site was significantly higher. Patient adherence and outcomes in the postdischarge period were not significantly different between the study sites.
CONCLUSIONS: This study demonstrated a nurse-led intervention achieved high adherence with translating evidence-based guidelines into routine patient care for hip and knee arthroplasty patients. Nurses can be critical to implementing clinical practice guidelines and adopting preventive programmes in acute care to improve patient outcomes and reduce postoperative venous thromboembolism in arthroplasty patients.
CONCLUSIONS: This research demonstrates the capacity of nurses to lead the translation of evidence-based practice guidelines for prevention of venous thromboembolism into routine patient care.

The volume of hip arthroplasty is stiffly increasing because of excellent clinical outcomes, however it has not been shown to decrease the incidence of transfusions due to bleeding related to this surgery. This is an important consideration since there are concerns about the side effects and social costs of transfusions. First, anemia should be assessed at least 30 days before elective hip arthroplasty, and if the subject is diagnosed as having anemia, an additional examination of the cause of the anemia should be carried and steps taken to address the anemia. Available iron treatments for anemia take 7 to 10 days to facilitate erythropoiesis, and preoperative iron supplementation, either oral or intravenous, is recommended. When using oral supplements for iron storage, administer elemental iron 100 mg daily for 2 to 6 weeks before surgery, and calculate the dose using intravenous supplement. Tranexamic acid (TXA) is a synthetic derivative of the lysine component, which reduces blood loss by inhibiting fibrinolysis and clot degradation. TXA is known to be an effective agent for reducing postoperative bleeding and reducing the need for transfusions in primary and revision total hip arthroplasties. Patient blood management has improved the clinical outcome after hip arthroplasty through the introduction and research of various agents, thereby reducing the need for allogeneic blood transfusions and reducing the risk of transfusion-related infections and the duration of hospitalizations.