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Level 1 study supports mobilization without the use of aids after THR

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COPENHAGEN — Mobilization without the use of aids after total hip replacement may be prescribed without an increased risk of complications, according to a study presented at the 12th EFORT Congress 2011 here.

Michael Skettrup said the findings suggest that the use of aids for activities of daily living after total hip replacement (THR) is unnecessary and may imply potential rehabilitation savings.

“We think this study is interesting because it questions, in some aspects, how we treat our patients the same way as we have treated them for the past 30 years despite progresses,” Skettrup said during his presentation.

The study investigated 80 patients who underwent uncemented THR and were randomized to either postoperative movement restriction and the use of aids, or movement without the use of aids. Immediate weight bearing was allowed in both groups. Walking speed, Timed-Up-and-Go test scores and visual analog scale pain scores were evaluated by the team, as well as a trained physiotherapist who examined patients preoperatively, twice daily during admission and at 14 days and 90 days postoperatively. Radiographs were also taken at 3 days and 3 months postoperatively. SF-36 scores were also taken after 3 months postoperatively.

Skettrup reported no postoperative dislocations in the study and reported no significant differences between the groups for all of the registered parameters. He noted that pain scores differed between the two groups, although this difference was not significant. The group without restrictions had a higher pain score than the group without — a difference that remained for several days postoperatively.

The two groups were similar 3 months postoperatively, with SF-36 scores that did not differ significantly.

“We think that mobilization without restriction is a natural part of the fast track surgery and is a natural part of the fast track surgery evolution,” Skettrup said.

Reference:

• Skettrup M, Kjersgaard AG, Colding C, Solgaard S. Are postoperative restrictions of movements after total hip replacement necessary? A prospective randomized study of 80 total hip replacements. Paper #998. Presented at the 12th EFORT Congress 2011. June 1-4. Copenhagen.

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