Hip precautions not meaningful after hemiarthroplasty due to hip fracture. Cluster-randomized study of 394 patients operated with direct anterolateral approach |
| |
| Institution: | 1. Department of Orthopedics, Skane University Hospital, Malmö, Sweden;2. Lund University, Department of Clinical Sciences, Malmö, Sweden;3. Swedish Hip Arthroplasty Register, Center for Registers, Västra Götaland, Gothenburg, Sweden;4. Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;1. Department of Orthopaedics, The Ohio State University Wexner Medical Center, United States;2. Department of Biomedical Informatics, The Ohio State University, United States;3. Department of Surgery, The Ohio State University Wexner Medical Center, United States;4. Center for Surgical Health Assessment, Research and Policy (SHARP), The Ohio State University Wexner Medical Center, United States;1. Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China;2. Department of Joint Surgery, The First People’s Hospital of Kunshan, Suzhou, Jiangsu, 215300, China;1. Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, Australia;2. Centre for Research Excellence in Recovery Following Road Traffic Injuries, Australia;1. School of Medicine, Monash University, Melbourne, VIC, Australia;2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia;3. Health Data Research, UK |
| |
| Abstract: | AimsWe aimed to compare two treatment regimes, one with and one without postoperative precautions in hemiarthroplasty patients, in terms of dislocation rate and patient-reported outcome. Direct lateral approach was used.Patients and Methods394 patients were included in a cluster-randomized study 2010−2014. Depending on which ward they were admitted to, they were allotted to free rehabilitation (non-precaution group, NPG, n = 226) or our conventional regime with precautions and mandatory assistive equipment (precaution group, PG, n = 168). Patients were followed during hospital stay, at 6 weeks (postal questionnaire), 3 month (visit) and 6 months (reading of medical records) by means of function tests, health-related quality of life (EQ-5D) and other patient-reported outcome measures (PROM).ResultsOne patient in each group had dislocation(s). We found no statistically significant differences regarding in-hospital-mortality, severe adverse events, EQ5D index or other PROM. In the NPG, rehabilitation personnel had significantly shorter work effort during hospital stay (p < 0.001). 7 in the NPG and 13 of the PG had reoperations (p = 0.038), 4 and 8 had deep infections, 3 and 5 periprosthetic fractures.ConclusionRehabilitation precautions are not needed for preventing dislocation when direct lateral approach is used. Without precautions, rehabilitation personnel implement significantly shorter work effort during hospital. We found no statistically significant differences regarding PROM and complications except for somewhat more reoperations in total in the precaution group. |
| |
| Keywords: | Femoral neck fracture Hemiarthroplasty Dislocation Precautions Assistive device Rehabilitation Patient-Reported outcome |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
