Blog
About

6
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Hip precautions after total hip replacement and their discontinuation from practice: patient perceptions and experiences

      Read this article at

      ScienceOpenPublisher
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Related collections

          Most cited references 15

          • Record: found
          • Abstract: found
          • Article: not found

          The role of patient restrictions in reducing the prevalence of early dislocation following total hip arthroplasty. A randomized, prospective study.

          It is currently unknown whether functional restrictions following total hip arthroplasty can reduce the prevalence of early postoperative dislocation. Our hypothesis was that dislocation was more likely to occur in patients who were not placed on these restrictions. We performed a prospective, randomized study to evaluate the role of postoperative functional restrictions on the prevalence of dislocation following uncemented total hip arthroplasty through an anterolateral approach. Of the 630 eligible consecutive patients, 265 patients (303 hips) consented to be randomized into one of two groups (the "restricted" group or the "unrestricted" group). The patients in both groups were asked to limit the range of motion of the hip to <90 degrees of flexion and 45 degrees of external and internal rotation and to avoid adduction for the first six weeks after the procedure. The patients in the restricted group were instructed to comply with additional hip precautions during the first six weeks postoperatively. Specifically, these patients were managed with the placement of an abduction pillow in the operating room before bed transfer and used pillows to maintain abduction while in bed; used elevated toilet seats and elevated chairs in the hospital, in the rehabilitation facility, and at home; and were prevented from sleeping on the side, from driving, and from being a passenger in an automobile. All patients were followed for a minimum of six months postoperatively. There was one dislocation in the entire cohort (prevalence, 0.33%). This dislocation occurred in a patient in the restricted group during transfer from the operating table to a bed with an abduction pillow in place. Patients in the unrestricted group were found to return to side-sleeping sooner (p < 0.001), to ride in automobiles more often (p < 0.026), to drive automobiles more often (p < 0.001), to return to work sooner (p < 0.001), and to have a higher level of satisfaction with the pace of their recovery (p < 0.001) than those in the restricted group. There was an additional expenditure of approximately $655 per patient in the restricted group. Total hip arthroplasty through an anterolateral approach is likely to be associated with a low dislocation rate. Removal of several restrictions did not increase the prevalence of dislocation following primary hip arthroplasty at our institution. However, it did promote substantially lower costs and was associated with a higher level of patient satisfaction as patients achieved a faster return to daily functions in the early postoperative period.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Sleep disruptions mediate the relationship between early postoperative pain and later functioning following total knee replacement surgery.

            Despite relatively standardized surgical procedures, patients undergoing total knee replacement (TKR) surgery differ dramatically in the speed of their recovery. Previous research has suggested a relationship between the experience of pain and sleep disruptions among patients with chronic pain or those undergoing surgery, such that more severe pain is associated with more frequent awakenings throughout the night. This study examined sleep disruptions 1 month following surgery as a mediator of the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. A total of 110 patients scheduled to undergo unilateral TKR were examined at three time points: 2-3 weeks prior to surgery, 1 month following surgery, and 3 months following surgery. After controlling for presurgical levels of pain, sleep disruptions, and functional limitations, sleep disruptions 1 month following surgery partially mediated the relationship between pain 1 month following surgery and functional limitations 3 months following surgery. The present findings underscore the importance of adequate sleep during postsurgical recovery and suggest that interventions targeting sleep disruptions may improve the speed and quality of patients' recovery from TKR and other surgical procedures.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Restriction in participation in leisure activities after joint replacement: an exploratory study.

              currently, assessment of outcomes after joint replacement is predominantly centred on impairment and activity limitation (e.g. walking), with little consideration of participation restriction.
                Bookmark

                Author and article information

                Journal
                Disability and Rehabilitation
                Disability and Rehabilitation
                Informa UK Limited
                0963-8288
                1464-5165
                February 11 2020
                : 1-7
                Affiliations
                [1 ] Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham, UK;
                [2 ] Department of Orthopaedics, Nottingham University Hospitals NHS Trust – City Hospital, Nottingham, UK
                Article
                10.1080/09638288.2020.1722262
                © 2020

                Comments

                Comment on this article