Allen Felix C, Skinner Daniel L, Harrison Jane, Stafford Giles H
Elective Orthopaedic Centre, Epsom General Hospital, Epsom, Surrey, UK.
Hip Int. 2018 Sep;28(5):485-490. doi: 10.1177/1120700018762175. Epub 2018 Jun 7.
The efficacy of hip precautions in preventing dislocation post total hip arthroplasty (THA) has been questioned in recent literature. From 2014 our centre ceased routinely prescribing them due to lack of evidence. We investigate the effect of stopping these precautions on dislocation rate, patient satisfaction and Oxford hip score (OHS).
Patients who underwent primary total hip arthroplasty prior to this change in protocol ( n = 2551) and for 1 year subsequently ( n = 673) were identified. Operative records were used to identify key demographic and operative data. Incidence of dislocation, OHS and patient satisfaction were extracted from the centre's electronic database. Subset analysis of those patients dislocating within 6 weeks was performed.
Rate of dislocation at 6 weeks in those prescribed and not prescribed precautions was 0.71% and 0.89% respectively ( p = 0.618). At 1 year this rose to 1.25% and 1.49% ( p = 0.406). Satisfaction ( p = 0.332) and OHS ( p = 0.441) at 1 year was not significantly different between cohorts.
Cessation of prescribing routine hip precautions post primary THA does not appear to significantly affect overall dislocation rate, patient satisfaction or functional status at 1 year post-operatively.
近期文献对髋关节置换术后预防脱位的髋关节预防措施的有效性提出了质疑。自2014年起，由于缺乏证据，我们中心停止了常规开具这些预防措施。我们调查了停止这些预防措施对脱位率、患者满意度和牛津髋关节评分（OHS）的影响。
确定在方案改变之前接受初次全髋关节置换术的患者（n = 2551）以及随后1年的患者（n = 673）。手术记录用于确定关键的人口统计学和手术数据。从中心的电子数据库中提取脱位发生率、OHS和患者满意度。对在6周内发生脱位的患者进行亚组分析。
接受和未接受预防措施的患者在6周时的脱位率分别为0.71%和0.89%（p = 0.618）。在1年时，这一比例分别升至1.25%和1.49%（p = 0.406）。两组患者在1年时的满意度（p = 0.332）和OHS（p = 0.441）没有显著差异。
初次全髋关节置换术后停止常规开具髋关节预防措施似乎对术后1年的总体脱位率、患者满意度或功能状态没有显著影响。
