Design: Prospective three-arm randomised controlled trial
Population: 79 patients undergoing primary total hip arthroplasty
Primary outcome: Length of stay and satisfaction with education
Effect: No difference in length of stay (p=0.525) or satisfaction (p=0.997)

A three-arm randomised trial in Acta Orthopaedica Belgica (8 October 2026) allocated 79 patients awaiting primary total hip arthroplasty to a booklet with clinic information, the same plus a live group session, or the same plus a mobile app.

Mean length of stay was about 4.3 days with no difference between groups (p=0.525). Satisfaction with the education method and content did not differ, and hip and quality-of-life scores improved similarly in all groups. App users reported slightly more motivation to exercise, which was not significant.

The trial is small and the length of stay is long by current enhanced-recovery standards, so a modest effect could have been missed. Still, it suggests extra education formats should not be expected to shorten stay on their own; pathway elements such as early mobilisation are more likely to matter.

Keep a clear written booklet as the core of pre-arthroplasty education
Do not expect an app or extra session alone to shorten length of stay
Weigh the cost of extra education formats against limited measured benefit

Why it matters

Units investing in education apps should not expect them to drive discharge on their own.

The statistics, in plain English

With about 25 patients per arm the trial could only detect large differences, so 'no significant difference' here means no large effect rather than proof of no effect.