Do Hip Precautions Matter After Posterior Approach Total Hip Arthroplasty With Capsular Repair? A Randomized Control...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• The effectiveness of posterior hip precautions in preventing dislocation after posterior approach total hip arthroplasty (THA) is not well-established.
• Mobility restrictions associated with these precautions may impede patients' functional recovery and return to daily activities.

Purpose of the Study:

• To investigate whether adherence to hip precautions impacts dislocation rates following primary posterior approach THA.
• To evaluate the effect of hip precautions on functional recovery and patient-reported outcomes.

Main Methods:

• A prospective, randomized study involving 1,133 patients undergoing primary posterior approach THA.
• Patients were randomized into a restricted group (hip precautions) or an unrestricted group.
• Primary outcome was dislocation; secondary outcomes included complications and patient-reported outcomes (HOOS JR).

Main Results:

• No significant difference in dislocation rates between the restricted (0.88%) and unrestricted (0.88%) groups (OR: 0.60; P=0.547).
• The unrestricted group reported statistically higher Hip Disability and Osteoarthritis Outcome Scores Joint Replacement (HOOS JR) at six weeks and three to six months.
• No significant differences in 90-day complications or revisions were observed between groups.

Conclusions:

• Routine strict hip precautions following posterior approach THA with capsular repair did not demonstrate a reduced risk of dislocation.
• These precautions may unnecessarily limit early functional recovery, increase patient anxiety, and negatively affect patient-reported outcomes.