Inger Mechlenburg

Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement? A non-randomized, controlled study in 365 patients with six week follow up.

Publikation: KonferencebidragKonferenceabstrakt til konferenceForskningpeer review

Rehabilitation after total hip replacement (THR) has traditionally included movement restrictions to prevent hip dislocation. Improvements in surgical techniques and increased femoral head size might have changed the rationale for these restrictions.

Purpose/Aim of Study
To evaluate the influence of movement restrictions and assistive devices on rehabilitation after fast track THR.

Materials and Methods
365 primary THR patients (mean age 68.7±10 years, 52% males) were consecutively included. The 3 initial months, patients underwent rehabilitation with movement restrictions and received a standard package of assistive devices (restricted group, RG). This group was compared to patients included into the study the following 3 months with a less restricted hip movement regime and use of assistive devices according to individual needs (unrestricted group, UG). Questionnaires on function (primary outcome, HOOS), anxiety (HADS), working status and patient satisfaction were administered before THR, 3 and 6 weeks after.

Findings / Results
HOOS function score at the 3 measurement times were (mean ± SD); UG: 46±17 - 76±9 - 83±14 compared to RG: 43±16 – 81±14 - 83±13, (difference between groups over time, p=0.004). For return to work 6 weeks post THR, UG compared to RG: 53% versus 32% (p=0.045). No significant differences between groups in anxiety, hip dislocations and patient satisfaction.

No clinically relevant difference between UG and RG on patient evaluated function was found (difference ≤5 points). Yet, there is a beneficial or equal effect of the unrestricted regime concerning secondary outcomes. It seems possible to reduce the use of assistive devices considerably and thereby induce cost savings. More research on safety issues is needed to elucidate the effect of unrestricted rehabilitation on hip dislocation.
StatusUdgivet - 2013
BegivenhedDOS kongres - København, Danmark
Varighed: 23 okt. 201325 okt. 2013


KonferenceDOS kongres

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