AUTHORS ' CONCLUSIONS Very low quality evidence is available from single trials , thus we are uncertain if hip pre caution s with or without the addition of equipment and functional restrictions are effective in preventing dislocation and improving outcomes after THA .
BACKGROUND Total hip arthroplasty ( THA ) is one of the most common orthopaedic operations performed worldwide .
Painful osteoarthritis of the hip is the primary indication for THA .
Following THA , people have conventionally been provided with equipment , such as raised toilet seats and chairs , and educated to avoid activities that could cause the hip joint to be in a position of flexion over 90 degrees , or adduction or rotation past the midline .
These aspects of occupational therapy have been advocated to reduce the risks of prosthesis dislocation .
However , the appropriateness of these recommendations has been question ed .
OBJECTIVES To assess the effects of provision of assistive devices , education on hip pre caution s , environmental modifications and training in activities of daily living ( ADL ) and extended ADL ( EADL ) for people undergoing THA .
Early discharge and home intervention reduces unit costs after total hip replacement: results of a cost analysis in a randomized study
Total hip replacement ( THR ) is a common and costly procedure . The number of THR is expected to increase over the coming years . Two pathways of postoperative treatment were compared in a r and omized study . Fifty patients from two hospitals were r and omized into a study group ( SG ) of 27 patients receiving preoperative and postoperative education programs , as well as home visits from an outpatient team . A control group ( CG ) of 23 patients received “ conventional ” rehabilitation augmented by a stay at a rehabilitation center if needed . All costs for the two groups both in hospitals and after discharge were collected and analyzed . On average total costs for the SG were $ 8,550 and $ 11,952 for the CG , a 28 % cost reduction . Total inpatient costs were $ 5,225 for the SG and $ 6,515 for the CG . In a regression analysis the group difference is statistically significant . Adjusting for changes in the Oxford Hip Score gives effective costs ( C/E ) . The ratio of the SGs C/E to the CGs is 0.60 . That is a cost-effectiveness gain of 40 % . A shorter hospital stay augmented with better preoperative education and home treatment appears to be more effective and costs less than the traditional in hospital pathway of treatment
AUTHORS ' CONCLUSIONS Very low quality evidence is available from single trials , thus we are uncertain if hip pre caution s with or without the addition of equipment and functional restrictions are effective in preventing dislocation and improving outcomes after THA .
BACKGROUND Total hip arthroplasty ( THA ) is one of the most common orthopaedic operations performed worldwide .
Painful osteoarthritis of the hip is the primary indication for THA .
Following THA , people have conventionally been provided with equipment , such as raised toilet seats and chairs , and educated to avoid activities that could cause the hip joint to be in a position of flexion over 90 degrees , or adduction or rotation past the midline .
These aspects of occupational therapy have been advocated to reduce the risks of prosthesis dislocation .
However , the appropriateness of these recommendations has been question ed .
OBJECTIVES To assess the effects of provision of assistive devices , education on hip pre caution s , environmental modifications and training in activities of daily living ( ADL ) and extended ADL ( EADL ) for people undergoing THA .