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Feasibility of repeated early mobilization in orthostatic intolerance after total hip arthroplasty
Mikkel Nicklas Frandsen1, Jesper Mehlsen1, Claus Varnum2
1Section for Surgical Pathophysiology, Rigshospitalet, Ole Maaløes 26, 2200, København N, Denmark.
Introduction:
Orthostatic intolerance (OI) is a barrier for early mobilization and same-day discharge after total hip arthroplasty (THA), with an estimated 30 % of patients affected within the first 6 h after surgery. Since repeated mobilization is known to be valuable in non-surgical OI conditions, we aimed to evaluate the feasibility of an early standardized repeated mobilization procedure as treatment of postoperative OI after THA.
Methods:
This study was a single-arm, two-center hypothesis-generating feasibility study in patients undergoing THA. At first mobilization 4 h after surgery patients were categorized as having orthostatic tolerance (OT) or OI. Patients with OI underwent an hourly standardized repeated mobilization procedure until achieving OT or reaching 8 h post-surgery.
Results:
Of 84 patients screened for OI, 25 (30 %) had OI 4 h postoperatively. Four patients left the study before achieving OT. Of the 21 completing the study per protocol, 16 patients achieved OT at 5 h and the remaining 5 achieved OT at 6 h postoperatively.
Discussion:
Early repeated mobilization in patients with postoperative OI was feasible and potentially valuable after THA. This hypothesis-generating study calls for future large-scale studies in surgical patients with OI.
