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Rehabilitation of revision total hip replacement: A multi‐centre survey of current practice
Author(s) -
Newman Meredith,
Barker Karen
Publication year - 2017
Publication title -
musculoskeletal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 28
eISSN - 1557-0681
pISSN - 1478-2189
DOI - 10.1002/msc.1187
Subject(s) - rehabilitation , medicine , retraining , psychological intervention , physical therapy , population , medical prescription , physical medicine and rehabilitation , nursing , environmental health , international trade , business
Background Demand for revision total hip replacement (RTHR) is increasing. Outcomes after RTHR are varied, with reasonable pain relief but smaller gains in function and mobility. Whether sub‐optimal rehabilitation contributes to poorer functional outcomes is unclear. Current rehabilitation is not well defined and there is little research into RTHR rehabilitation. Aims and objectives To gather information about the current rehabilitation of patients undergoing planned, single‐stage revision or re‐revision THR surgery. Methods An online survey was developed and sent to clinicians at 117 orthopaedic centres in England, Wales and Northern Ireland. Questions were asked about standard rehabilitation practice pre‐operatively, post‐operatively and immediately after discharge. The frequency (%) of responses to closed questions was analysed and free‐text comments were summarized thematically. Results There were 133 respondents: mostly physiotherapists (92, 69%) and occupational therapists (39, 29%). Pre‐operative education was common (112, 84%) but not uniform, and for 52 (46%) the same as for primary THR patients. Respondents were more likely to agree about the general objectives of rehabilitation, for example gait re‐education with walking aids (93, 70%), and retraining functional mobility (92, 69%) rather than about specific elements including exercise prescription, duration of hip precautions and provision of occupational therapy. The provision of rehabilitation following discharge varied considerably. Conclusions This survey adds to sparse information about rehabilitation RTHR. No consensus emerged about optimal rehabilitation. The diversity in approach and lack of clear structure suggests work is needed to develop rehabilitation interventions that are tailored to this population.