Dislocation Precautions

Study Overview
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Brief Summary
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This study is looking at the impact of giving patients precautions, or restrictions for movement, when undergoing a total hip replacement. Have of the participants will receive precautions, while the other half will not receive any precautions.

Detailed Description
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Patients undergoing hip replacements are often told by health care providers to avoid specific positions and activities to decrease the risk of their hip dislocating following their surgery. This, however, results in patients becoming more fearful of moving and leads to limitations in their function and decreased quality of life. Previous research has shown that hip dislocations following surgery are most commonly attributed to poor implant position rather than the actions of the patients. Teaching precautions takes up healthcare resources and may use finances that are not necessarily required. This study aims to compare groups with half receiving precautions and half not receiving precautions, to assess the impact of precautions on the patients' quality of life.

Official Title
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Impact of Dislocation Precautions on Fear and Function in Patients Undergoing Hip Replacement

Conditions
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Arthroplasty, Hip Replacement, Arthroplasties, Hip Replacement, Health-Related Quality Of Life

Intervention / Treatment
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* Procedure: Posterior Approach Precautions
* Procedure: Anterior Approach Precautions
* Procedure: No Precautions


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Receiving a primary total hip arthroplasty (THA) due to osteoarthritis or osteonecrosis Over 18 Willing and able to sign consent Exclusion Criteria: Receiving a lateral approach hip arthroplasty Cannot make follow up visits

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Anterior Approach Precautions<br>This group receives precautions and have a total hip arthroplasty with a posterior approach. | Procedure: Anterior Approach Precautions<br>* These patients will be advised to avoid extending the leg back, rotating the leg outwards, and lifting their bottom when lying down after their surgery for 6 weeks.<br>|
| Other: Posterior Approach Precautions<br>This group receives precautions and have a total hip arthroplasty with a posterior approach. | Procedure: Posterior Approach Precautions<br>* These patients will be advised not to bend their leg or trunk more than 90 degrees, avoid crossing the leg or crossing midline, and rotating the leg inwards. Patients will also be instructed to put a pillow in between their legs while sleeping for 6 weeks and to avoid bathing for 6 weeks.<br>|
| Other: Anterior Approach No Precautions<br>This group receives does not precautions and have a total hip arthroplasty with an anterior approach. | Procedure: No Precautions<br>* For the non-precautions group, there will be no mention of precautions by any providers before, during, and after surgery. No equipment will be given, but a list of self-care equipment will be available for 'comfort' purposes. Patients will be instructed to avoid bathing for 4 weeks. All groups will have instructions to use a walking aid and a toilet seat if needed, to weight-bear as tolerated, and to avoid driving for 3 weeks.<br>|
| Other: Posterior Approach No Precautions<br>This group receives does not receive precautions and have a total hip arthroplasty with a posterior approach. | Procedure: No Precautions<br>* For the non-precautions group, there will be no mention of precautions by any providers before, during, and after surgery. No equipment will be given, but a list of self-care equipment will be available for 'comfort' purposes. Patients will be instructed to avoid bathing for 4 weeks. All groups will have instructions to use a walking aid and a toilet seat if needed, to weight-bear as tolerated, and to avoid driving for 3 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Oxford Hip Score | Assess function of the hip | Week before surgery to 6 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Tampa Scale for Kinesiophobia | This assesses kinesiophobia, using a 17 item scale with each item using a 4 point Likert scale . The final score is the sum of all questions except for 4, 8, 12 and 16 which has their score inverted before being added. The final score ranges from from 17-68 points with 68 being the highest degree of kinesiophobia. | Week before surgery to 6 months after surgery | 
| Change in Forgotten Joint Score | This measures awareness of a replaced joint | 6 weeks after surgery to 6 months after surgery | 
| Change in EQ-5D-5L | This measures general health | Week before surgery to 6 months after surgery | 
| Canadian Patient Experience Survey - Inpatient Care (CPES-IC) | This will measure the patients' experience. | At 2 weeks after surgery |