Less Postoperative Restrictions Following Total Hip Arthroplasty With Use of a Posterolateral Approach: A Prospective, Randomized, Noninferiority Trial

Peters, Anil; Weele, Kirstin ter; Manning, Fokko; Tijink, Miranda; Pakvis, D.F.M.; Veld, Rianne Huis in het

doi:10.1016/j.arth.2019.05.038

Cited by 14 publications

(30 citation statements)

References 20 publications

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“…The updated searches identified 1,860 unique references, of which 67 were screened in full text. Of these, 59 were excluded, leaving four new RCTs [49][50][51][52] and four new NRS 28,53-55 for inclusion. Figure 1 shows the study selection process.…”

Section: Study Selectionmentioning

confidence: 99%

“…In the four single-center RCTs, 1,616 patients were randomized to either hip precautions or no or minimal precautions for six 49,50,52 or eight 51 weeks. In the intervention groups, all patients were at least instructed to avoid hip flexion beyond 90°, adduction beyond the midline, and internal rotation, with Peters et al limiting patients to supine sleeping.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In the intervention groups, all patients were at least instructed to avoid hip flexion beyond 90°, adduction beyond the midline, and internal rotation, with Peters et al limiting patients to supine sleeping. 51 Assistive devices were not routinely prescribed.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Patients in the control groups were not instructed to follow any precautions in three trials, 49,50,52 and Peters et al, patients were advised to avoid the combination of hip flexion beyond 90°, adduction beyond the midline, and internal rotation. 51 See Table 1 for study characteristics.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Hip precautions after posterior approach total hip arthroplasty among patients with primary hip osteoarthritis do not influence early recovery: a systematic review and meta-analysis of randomized and non-randomized studies with 8,835 patients

Korfitsen¹,

Mikkelsen²,

Mikkelsen³

et al. 2022

Preprint

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Background and purpose: Hip precautions are routinely prescribed to patients with osteoarthritis to decrease dislocation rates post total hip arthroplasty (THA) using a posterior approach. However, recommendations have been based on very low certainty of evidence. This systematic review aimed to update the evidence on the influence of hip precautions on early recovery following THA.Materials and methods: We performed systematic searches for published randomized controlled trials (RCT) and non-randomized (NRS) studies in MEDLINE, Embase, PEDro, and CINAHL from 2016 to July 2022. Two reviewers independently included studies comparing postoperative precautions with minimal or no precautions, extracted data, and assessed the risk of bias. Random effects meta-analyses were used to synthesize the results. The certainty of the evidence was rated by the Grading of Recommendations Assessment and Evaluation approach. The critical outcome was risk of hip dislocations within three months of surgery. Other outcomes were long-term risk of dislocation, reoperation, levels of self-reported function, quality of life, pain, performance-based assessment of function, and time to return to work.Results: 4 RCTs and 5 NRSs, including 8,835 participants, were included. Certainty in the evidence was low. There may be no or negligible difference in early hip dislocations (RCT: risk ratio (RR): 1.8, 95% confidence interval (CI) 0.6 - 5.2; NRS: RR: 0.9, CI 0.3 - 2.5). For all other outcomes, no differences were found.Interpretation: The current evidence does not support routinely prescribing hip precautions post-surgically for patients undergoing THA. However, the certainty in the estimates is moderate to very low, and the results are likely to change with higher-quality studies.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Hip precautions after posterior approach total hip arthroplasty among patients with primary hip osteoarthritis do not influence early recovery: a systematic review and meta-analysis of randomized and non-randomized studies with 8,835 patients

Korfitsen¹,

Mikkelsen²,

Mikkelsen³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Hip precautions may delay return to normal activity, increase fall risk, and delay postoperative conditioning [15] by inducing fear in patients [16]. Thus, while imposing hip precautions may seem harmless, the potential for causing psychological distress and anxiety should be taken into consideration [17,18]. Hip precautions are widely used despite a dearth of clinical studies to support them [16,19].…”

mentioning

confidence: 99%

Patients Achieving 90°/45°/0° Intraoperative Stability Do Not Require Hip Precautions Following Posterior Approach Total Hip Arthroplasty: A Prospective Randomized Study

Mounts

Turner

Patel

et al. 2022

The Journal of Arthroplasty

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Durability of transosseous repair of posterior soft tissues after primary total hip arthroplasty: a prospective randomized controlled trial

Edipoğlu

2021

Arch Orthop Trauma Surg

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Less Postoperative Restrictions Following Total Hip Arthroplasty With Use of a Posterolateral Approach: A Prospective, Randomized, Noninferiority Trial

Cited by 14 publications

References 20 publications

Hip precautions after posterior approach total hip arthroplasty among patients with primary hip osteoarthritis do not influence early recovery: a systematic review and meta-analysis of randomized and non-randomized studies with 8,835 patients

Hip precautions after posterior approach total hip arthroplasty among patients with primary hip osteoarthritis do not influence early recovery: a systematic review and meta-analysis of randomized and non-randomized studies with 8,835 patients

Patients Achieving 90°/45°/0° Intraoperative Stability Do Not Require Hip Precautions Following Posterior Approach Total Hip Arthroplasty: A Prospective Randomized Study

Durability of transosseous repair of posterior soft tissues after primary total hip arthroplasty: a prospective randomized controlled trial

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