• Louise O H Daugberg, Henrik Kehlet, Pelle B Petersen, Thomas Jakobsen, Christoffer C Jørgensen, and Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement collaborative Group.
• Department of Orthopedic Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark. Louise.Daugberg@rn.dk.
• Arch Orthop Trauma Surg. 2023 Oct 1; 143 (10): 603360386033-6038.

IntroductionGastrointestinal complications after total hip (THA) and knee arthroplasty (TKA) have been reported to be between 0.3 and 2.6% with bleeding and C. difficile infection in 0-1%, and 0.1-1.7%, respectively. The use of enhanced recovery or "fast-track" protocols have focused on optimizing all aspects of perioperative care resulting in reduced length of hospital stay (LOS) and potentially also gastrointestinal complications. This study is a detailed analysis on the occurrence of postoperative gastrointestinal complications resulting in increased hospital stay or readmissions in a large consecutive cohort of fast-track THA and TKA with complete 90 days follow-up.Materials And MethodsThis is an observational study on a consecutive cohort of primary unilateral THAs and TKAs performed between January 2010 and August 2017 in nine Danish high-volume fast-track centers. Discharge summaries and relevant patient records were reviewed in patients with readmissions within 90 days or LOS > 4 days caused by gastrointestinal complications.ResultsThe cohort included 36,932 patients with 58.3% females and 54.1% THAs. Mean age and BMI were 68 years and 28. Median postoperative LOS was 2 days. Only n: 276 (0.75 %) had a LOS > 4 days or a readmission within 90 days due to a gastrointestinal complication (CI 0.67%-0.84%). Of these, only 34 (0.09%) were graded as severe ileus or gastrointestinal bleeding.ConclusionsThe risk of GI-complications within the first 90 postoperative days after fast-track THA and TKA was low (0.75%).© 2023. The Author(s).

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