Early Cognitive Changes in People 70 Years and Older After Same-Day Discharge Hip and Knee Replacement Surgery

What this Trial Is About

This observational study explores early cognitive changes in patients aged 70 years or older undergoing same-day discharge after hip or knee replacement surgery. It aims to understand whether there are changes in cognitive test performance from before surgery to the first day after surgery. The study focuses on elderly patients receiving spinal anesthesia as part of fast-track surgical protocols designed to reduce hospital stay and improve recovery. Participants will complete cognitive tests virtually about 14 days before surgery and on the first and seventh days after their operation. Cognitive tests include the Symbol Digit Modality Test, Stroop Color Test, and verbal fluency test. Pain levels and pain medicine use will also be recorded during the first week after surgery. The surgery involves unilateral total hip arthroplasty, total knee arthroplasty, or unicompartmental knee arthroplasty with planned discharge on the day of surgery. Participants will be assessed remotely in their homes to keep testing conditions consistent and reduce practice effects. Data on cognitive performance and patient-reported cognitive function will be collected, alongside pain and medication use. The primary measure is the change in Symbol Digit Modalities Test score from baseline to postoperative day 1. Follow-up tests on day 7 will also evaluate cognitive changes. The study continues until November 2026, with patient involvement in study design to ensure relevance and feasibility.

Early Cognitive Changes After Same-day Discharge Hip and Knee Arthroplasty