Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK.
Department of Orthopaedics, Nottingham University Hospitals NHS Trust - City Hospital, Nottingham, UK.
Disabil Rehabil. 2021 Oct;43(20):2890-2896. doi: 10.1080/09638288.2020.1722262. Epub 2020 Feb 11.
Hip precautions are routinely provided to reduce the risk of dislocation following total hip replacement despite evidence suggesting they provide no additional benefit and may, actually, impede recovery. Our aim was to report the views of patients who had been recruited into a trial comparing outcomes in participants who were prescribed hip precautions with those who were not.
Semi-structured interviews were conducted. Topics explored included experiences and opinions of the service (either hip precautions or no hip precautions), information offered, and equipment provided. Thematic analysis was used to identify and report themes.
Six themes were identified: perceived justification, and advantages and disadvantages for the postoperative recovery regime prescribed, perceived risk, and fear of dislocation, adherence to the postoperative regime prescribed, and experiences of adaptive equipment.
Participants who received hip precautions had mixed views about their use: some felt they were restrictive whilst others believed they provided reassurance. Participants who did not receive hip precautions were less anxious about dislocating their hip but were unsure how to progress their rehabilitation. The discontinuation of precautions may decrease patients' fears about dislocation but more guidance from rehabilitation staff about how to move safely during recovery is required.Implications for rehabilitationHip precautions may unnecessarily exacerbate patients' anxieties and fear about dislocation following total hip replacement.Hip precautions impact on patients' recovery both physically and psychologically.Patients should be advised about moving and returning to activities following total hip replacement, whether they receive hip precautions or not.
尽管有证据表明髋关节预防措施并不能提供额外的益处，实际上可能会阻碍康复，但髋关节预防措施仍被常规用于降低全髋关节置换术后脱位的风险。我们的目的是报告曾参与一项试验的患者的观点，该试验比较了接受髋关节预防措施和不接受髋关节预防措施的参与者的结局。
进行了半结构化访谈。探讨的主题包括对服务（髋关节预防措施或无髋关节预防措施）的体验和看法、提供的信息以及提供的设备。采用主题分析来识别和报告主题。
确定了 6 个主题：术后恢复方案规定的预防措施的感知合理性、优势和劣势，感知风险和脱位恐惧，对规定的术后方案的依从性，以及适应性设备的使用体验。
接受髋关节预防措施的患者对其使用有不同的看法：一些人认为它们具有限制性，而另一些人则认为它们提供了安心。未接受髋关节预防措施的患者对髋关节脱位的焦虑程度较低，但不确定如何进行康复。停止预防措施可能会降低患者对脱位的恐惧，但需要康复人员提供更多关于如何在康复期间安全移动的指导。
髋关节预防措施可能会不必要地加剧全髋关节置换术后患者对脱位的焦虑和恐惧。髋关节预防措施会对患者的身体和心理康复产生影响。无论患者是否接受髋关节预防措施，都应告知他们在全髋关节置换术后如何移动和恢复活动。
