Is convention hip precaution necessary after total hip arthroplasty?

Autor: Vincent WK Chan, MT Chan, PK Chan, CH Yan, KY Chiu
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Journal of Orthopaedics, Trauma and Rehabilitation, Vol 28 (2021)
Druh dokumentu: article
ISSN: 2210-4925
22104917
DOI: 10.1177/22104917211006892
Popis: Background: Dislocation is one of the most common causes of revision after total hip arthroplasty (THA). Standard hip precautions are thought to enhance soft-tissue healing and reduce dislocations. However, lifestyle restrictions affect a patient’s rehabilitation, quality of life (QOL), and satisfactions. We aim to compare conventional (CP) and minimal hip precautions (MP) after THA. Methods: Retrospective review of prospectively collected data in posterolateral approach THA. Chief surgeon assigns patients to CP or MP group. CP group had to sleep supine, used elevated toilet seats and chairs, avoid hip flexion greater than 90°, and no internal rotation or adduction for 6 weeks. MP group had no restrictions in hip movements, except for the combined flexion, adduction and internal rotation. All had a minimum 1-year follow-up. The number of dislocations, length of stay (LOS), time to independent toileting, Harris Hip Scores, QOL, and health perceptions, assessed by EuroQol 5D-5L, was compared between CP and MP groups. Results: Fifty-five THAs were included. CP group consisted of 17 primary and 12 revision THAs; MP group consisted of 21 primary and 5 revision THAs. There were two dislocations and both are revisions in CP group. Overall rate of dislocation was 6.9% in CP group and no dislocation in MP group (p-value > 0.05). MP group had shorter LOS (12 vs 19 days, p-value 0.04), higher EQ5D-5L health perception scores at 1-year (81.7 vs 70.9, p-value 0.01). Conclusion: MP group had shorter LOS and better health perceptions 1-year after THA with no increase in dislocation rates.
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