Two simple functional performance-based tests have a significant added value to a more conventional screening with age and comorbidities to predict recovery of functioning immediately after total hip surgery. Patients over 70 years old, with comorbidities, with a TUG score >10.5 s and a walking speed >1.0 m/s are at risk for delayed recovery of functioning. Those high risk patients need an accurate discharge plan and could benefit from targeted pre- and postoperative therapeutic exercise programs.

BackgroundEstablishing patient criteria is one of the most important steps before implementing short stay total hip arthroplasty (THA). Most existing risk models are mainly based on medical condition, but as physical functioning is associated with outcome after THA, we assume a measure of physical functioning might be of added value to predict short-stay THA.MethodsWe used retrospective data of 1559 patients who had anterior THA. Logistic regression analyses were done to study the predictive value of preoperative physical functioning by use of the Timed Up and Go test (TUG), in a basic model with age, and the American Society of Anesthesiologists (ASA)-score for short stay THA (<36 hours). The receiver operating characteristic (ROC) curve was use to define a cut off point for TUG associated with LOS.Results TUG was significantly associated with LOS (OR 0.84, 95%CI 0.82-0.87) in univariate regression analysis. In multivariate regression, a model with the TUG had a better performance with an AUC of 0.77 (95%CI 0.74-0.79) and R2 of 0.27 then the basic model (AUC 0.75, 95% CI 0.73-0.77, R2 0.24). Patients with a preoperative TUG less than 10 seconds had an OR of 3.64 (95%CI 2.86-4.62) of being discharged within 36 hours.ConclusionsPerformance based physical functioning, measured by the TUG, is associated with short stay THA. This knowledge will help in the decision-making process for the planning, expectations and needs in outpatient THA protocols with the advantage that the TUG is a simple and fast instrument to be carried out.