Hospital for Special Surgery study reevaluates precautions for total hip arthroplasty: 3 study details

Reevaluating precautions for hip surgery and moving toward short-stay and outpatient surgery are two ways researchers examined necessary interventions for hip replacement patients, according to research conducted by New York City-based Hospital for Special Surgery presented at the 2019 American Academy of Orthopaedic Surgeons Annual Meeting, March 12-16 in Las Vegas.

Researchers retrospectively reviewed posterior primary uncemented total hip replacement from January 2014 to June 2016 at Hospital for Special Surgery. Patients either followed a pose avoidance protocol, where they are advised to avoid moving in certain ways, or a set of standard precautions. The pose avoidance cohort was composed of 1,311 patients, who were followed up with at a minimum of six weeks. The researchers matched the pose avoidance cohort with a group of patients who followed standard posterior hip precautions.

The key study details to know:

1. There was not a significant difference in the number of dislocations between the two groups.

2. Peter Sculco, MD, the study's lead author, said standard postoperative precautions may not be necessary for patients without known risk factors for instability undergoing total hip arthroplasty through the posterior approach. Potential risk factors could include lumbar spine fusions, stroke and Parkinson's disease.

3. Dr. Sculco concluded, "The bottom line of the study is in recent years, we have learned more about interventions that matter after joint replacement and those that don't really have efficacy. In most patients, we got rid of powerful anticoagulants, for example, and we are moving toward a shorter stay and even outpatient arthroplasty for total hip replacement. Minimizing precautions and simplifying the postoperative recovery is part of the larger simplification of surgery where we are using more selected resources and interventions for people, instead of blanketing everyone with the same kind of protocols."

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