Unrestricted Rehabilitation Following Primary THA

Sunnybrook Health Sciences Centre

Status: Unknown

Conditions: Osteoarthritis, Hip

Treatments: Procedure: Standard rehabilitation; Procedure: Unrestricted rehabilitation

Study type: Interventional

Funder types: Other

Identifiers

NCT02079467

Miller-01

Details and patient eligibility

About

The purpose of this study is to determine whether the form of rehabilitation following primary total hip arthroplasty has an influence on patient satisfaction or functional performance in the eighteen weeks following surgery.

Full description

The current standard of care following total hip replacement is to restrict patient activity and range-of-motion with the goal of avoiding dislocation of the operative hip. These restrictions are commonly referred to as "hip precautions". Several recent studies have demonstrated these precautions may be safely abandoned with no increased risk of dislocation when the surgery is carried through an anterior/lateral approach. Previous work has failed to address the issue of patient satisfaction and functional performance when patients are managed with an unrestricted rehabilitation protocol post-operatively. We propose a prospective, randomized clinical trial to determine whether an unrestricted postoperative rehabilitation protocol has an impact on patient satisfaction and functional performance following primary total hip arthroplasty.

Enrollment: 10 estimated patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age greater than 50 years
• Undergoing primary total hip arthroplasty at Holland Orthopaedic and Arthritic Centre

Exclusion criteria

• Any previous surgery about the ipsilateral hip
• Patients being considered for simultaneous bilateral total hip arthroplasty
• Patients with a neuromuscular disorder or recognized hypermobility syndrome
• Patients without sufficient language skills to communicate in spoken and written English

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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10 participants in 2 patient groups

Standard rehabilitation

Active Comparator group

Description:

Patients randomized to the control group will be managed with "hip precautions" immediately following surgery. They will weight bear on the operative joint as tolerated after surgery. They will be managed as per usual protocol post total hip arthroplasty. They will be transferred from the operative table with an abduction pillow between their legs and will be asked to keep this pillow between their legs while resting in bed and during sleep throughout their course in hospital. During physiotherapy treatments they will not flex the operative hip beyond 90 degrees, internally or externally rotate the operative hip more than 45 degrees, or actively adduct the operative hip past neutral.

Treatment:

Procedure: Standard rehabilitation

Unrestricted rehabilitation

Experimental group

Description:

Patients randomized to the treatment group will have no restrictions in their post-operative rehabilitation. They will weight bear on the operative joint as tolerated after surgery. They will be asked to participate in activity as their level of comfort permits and will have no positional restrictions while in bed or completing activities of daily living.

Treatment:

Procedure: Unrestricted rehabilitation