Smith T O, Sackley C M
School of Health Sciences, University of East Anglia, Queen's Building, School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
Division of Health and Social Care Research, King's College, London, UK.
BMC Musculoskelet Disord. 2016 May 25;17:228. doi: 10.1186/s12891-016-1092-x.
Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR.
A 27-question, self-administered online survey was developed and distributed to UK physiotherapists and occupational therapists involved in the management of people following primary THR (target respondents). The survey included questions regarding the current practices in the provision of equipment and hip precautions for THR patients, and physiotherapist's and occupational therapist's attitudes towards these practices. The survey was disseminated through print and web-based/social media channels.
170 health professionals (87 physiotherapists and 83 occupational therapists), responded to the survey. Commonly prescribed equipment in respondent's health trusts were raised toilet seats (95 %), toilet frames and rails (88 %), furniture raises (79 %), helping hands/grabbers (77 %), perching stools (75 %) and long-handled shoe horns (75 %). Hip precautions were routinely prescribed by 97 % of respondents. Hip precautions were most frequently taught in a pre-operative group (52 % of respondents). Similarly equipment was most frequently provided pre-operatively (61 % respondents), and most commonly by occupational therapists (74 % respondents). There was variability in the advice provided on the duration of hip precautions and equipment from up to 6 weeks post-operatively to life-time usage.
Current practice on hip precautions and provision of equipment is not full representative of clinician's perceptions of best care after THR. Future research is warranted to determine whether and to whom hip precautions and equipment should be prescribed post-THR as opposed to the current 'blanket' provision of equipment and movement restriction provided in UK practice.
全髋关节置换术（THR）是英国最常见的骨科手术之一。从历史上看，接受全髋关节置换术的患者会被给予髋关节防护措施及设备，如加高马桶座圈和家具增高装置，以降低术后脱位风险。本研究的目的是确定英国目前为初次接受全髋关节置换术的患者提供这些干预措施的实际情况。
设计了一份包含27个问题的在线自填式调查问卷，并分发给参与初次接受全髋关节置换术患者管理的英国物理治疗师和职业治疗师（目标受访者）。该调查包括有关为全髋关节置换术患者提供设备和髋关节防护措施的当前做法，以及物理治疗师和职业治疗师对这些做法的态度等问题。该调查通过印刷品和基于网络/社交媒体渠道进行传播。
170名医疗专业人员（87名物理治疗师和83名职业治疗师）回复了调查。受访者所在医疗信托机构中常用的处方设备有加高马桶座圈（95%）、马桶框架和扶手（88%）、家具增高装置（79%）、辅助把手/抓取器（77%）、折凳（75%）和长柄鞋拔（75%）。97%的受访者常规开出髋关节防护措施。髋关节防护措施最常在术前小组中教授（52%的受访者）。同样，设备最常在术前提供（61%的受访者），且最常由职业治疗师提供（74%的受访者）。关于髋关节防护措施和设备使用时长的建议存在差异，从术后长达6周至终身使用不等。
目前在髋关节防护措施和设备提供方面的做法并不能完全代表临床医生对全髋关节置换术后最佳护理的看法。有必要进行未来研究，以确定全髋关节置换术后是否以及应向谁开出髋关节防护措施和设备的处方，而不是像英国目前的做法那样“一概而论”地提供设备和限制活动。
