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. 2009 Jun;467(6):1400-11.
doi: 10.1007/s11999-009-0750-9. Epub 2009 Mar 10.

Factors influencing early rehabilitation after THA: a systematic review

Vivek Sharma  1 , Patrick M Morgan, Edward Y Cheng
Affiliations

Factors influencing early rehabilitation after THA: a systematic review

Vivek Sharma et al. Clin Orthop Relat Res. 2009 Jun.

Abstract

A wide variation exists in rehabilitation after total hip arthroplasty (THA) in part due to a paucity of evidence-based literature. We asked whether a minimally invasive surgical approach, a multimodal approach to pain control with revised anesthesia protocols, hip restrictions, or preoperative physiotherapy achieved a faster rehabilitation and improved immediate short-term outcome. We conducted a systematic review of 16 level I and II studies after a strategy-based search of English literature on OVID Medline, PubMed, CINAHL, Cochrane, and EMBASE databases. We defined the endpoint of assessment as independent ambulation and ability to perform activities of daily living. Literature supports the use of a multimodal pain control to improve patient compliance in accelerated rehabilitation. Multimodal pain control with revised anesthesia protocols and accelerated rehabilitation speeds recovery after minimally invasive THA compared to the standard approach THA, but a smaller incision length or minimally invasive approach does not demonstrably improve the short-term outcome. Available studies justify no hip restrictions following an anterolateral approach but none have examined the question for a posterior approach. Preoperative physiotherapy may facilitate faster postoperative functional recovery but multicenter and well-designed prospective randomized studies with outcome measures are necessary to confirm its efficacy.

Level of evidence: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1
Fig. 1
The flowchart of search history on OVID Medline database using the keywords for the four primary search questions is shown.
Fig. 2
Fig. 2
The flowchart of search history on CINAHL database using the keywords for the four primary search questions is shown.
Fig. 3
Fig. 3
The pie charts show distribution of the articles in each sub-category by their Level of Evidence.
See this image and copyright information in PMC

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References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '14987189', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/14987189/'}]}
    2. Ackerman IN, Bennell KL. Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review. Aust J Physiother. 2004;50:25–30. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1080/17453670710013654', 'is_inner': False, 'url': 'https://doi.org/10.1080/17453670710013654'}, {'type': 'PubMed', 'value': '17464604', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/17464604/'}]}
    2. Andersen KV, Pfeiffer-Jensen M, Haraldsted V, Soballe K. Reduced hospital stay and narcotic consumption, and improved mobilization with local and intraarticular infiltration after hip arthroplasty: a randomized clinical trial of an intraarticular technique versus epidural infusion in 80 patients. Acta Orthop. 2007;78:180–186. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '12375331', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/12375331/'}]}
    2. Arokoski MH, Arokoski JPA, Haara M, Kankaanpaa M, Vesterinen M, Niemitukia LH, Helminen HJ. Hip muscle strength and muscle cross sectional area in men with and without hip osteoarthritis. J Rheum. 2002;29:2185–2195. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1017/S026502150700302X', 'is_inner': False, 'url': 'https://doi.org/10.1017/s026502150700302x'}, {'type': 'PubMed', 'value': '18028577', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/18028577/'}]}
    2. Becchi C, Al Malyan M, Coppini R, Campolo M, Magherini M, Boncinelli S. Opioid-free analgesia by continuous psoas compartment block after total hip arthroplasty. A randomized study. Eur J Anaesthesiol. 2008;25:418–423. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.pain.2004.03.002', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.pain.2004.03.002'}, {'type': 'PubMed', 'value': '15275749', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/15275749/'}]}
    2. Berge DJ, Dolin SJ, Williams AC, Harman R. Pre-operative and post-operative effect of a pain management programme prior to total hip replacement: a randomized controlled trial. Pain. 2004;110:33–39. - PubMed

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