AB160. SOH26AB_0275. Routine post-operative urea and electrolytes are not required in primary elective total hip arthroplasty: a prospective cohort study
Orthopaedic Session II

AB160. SOH26AB_0275. Routine post-operative urea and electrolytes are not required in primary elective total hip arthroplasty: a prospective cohort study

Andre McLeod1, Kaja Czwojda2, Henry Turner1, James Cashman1

1Department of Orthopaedic Surgery, National Orthopaedic Hospital Cappagh, Dublin, Ireland; 2Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland

Background: Total hip arthroplasty (THA) is one of the most common orthopaedic procedures performed worldwide. Routine post-operative blood testing, including complete blood count (CBC) and urea and electrolytes (U&Es), has traditionally been a part of monitoring following THA; however, modern enhanced recovery after surgery (ERAS) protocols have challenged this practice in optimised patients. This study aims to evaluate the necessity of routine U&E testing in patients undergoing primary elective THA.

Methods: A retrospective review of prospectively collected data was performed. Data were collected from an institutional database regarding primary elective hip arthroplasty cases performed by a single surgeon at an urban tertiary referral centre (National Orthopaedic Hospital Cappagh) from 2018 to 2023. Patients undergoing bilateral or revision procedures were excluded. Pre-operative and post-operative U&Es were recorded (specifically renal function, sodium, and potassium), and pre-operative variables amongst patients were assessed to identify predictors of acute kidney injury (AKI) and electrolyte disturbance following THA.

Results: Three hundred and sixteen primary THAs were included in the study following application of exclusion criteria. The mean age was 67 [standard deviation (SD), 13; range, 16–89] years. Fourteen patients of AKI were recorded postoperatively with four patients requiring intravenous fluid replacement and ten requiring oral fluid intake only. In total, 17/317 (5.3%) received active treatment for a post-operative U&E disturbance. Oral replacement therapy was the only treatment provided for U&E disturbance.

Conclusions: Routine post-operative U&Es are not required in most patients undergoing elective primary THA. These post-operative tests should be reserved for patients with specific pre-operative risk factors.

Keywords: Acute kidney injury (AKI); electrolyte disturbance; enhanced recovery after surgery (ERAS); routine post-operative bloods; total hip replacement

Acknowledgments

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Footnote

Funding: None.

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-26-ab160
Cite this abstract as: McLeod A, Czwojda K, Turner H, Cashman J. AB160. SOH26AB_0275. Routine post-operative urea and electrolytes are not required in primary elective total hip arthroplasty: a prospective cohort study. Mesentery Peritoneum 2026;10:AB160.

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