[Comparison between early and late inpatient rehabilitation measures after implantation of total hip endoprostheses].

This study was aimed at answering the question of whether a four-week inpatient early rehabilitation programme, i.e. within the first two months following total hip replacement surgery, will have a favourable impact as compared to later-onset inpatient rehabilitation measures; a total of 219 patients was studied: 137 were admitted during the first two months post-op (group A), 45 within three to four months post op (group B), and 37 patients were admitted at a later date (group C). Assessments were carried out for pain, walking performance and self-help status (scores) as well as for mobility, gait patterns, walking aids, walking speed, and disablement. In group A patients, significant improvement was achieved for all of these parameters: at the end of the rehabilitation programme (2.4 months post-op) these patients already were more mobile than group B patients at the time of admission (3.3 months post-op). In group B, improvements were found for several parameters. At a later time, the natural healing process had brought about so good a baseline situation in the group C patients that no further improvement was possible. The 162 patients treated successfully, i.e. where score reductions occurred, had been admitted significantly (p = 0.0001) earlier (2.9 months post-op) than the remaining 57 patients (5.7 months post-op). Some 14 months after programme participation, follow-up examinations were possible for 90 patients of group A, and for 27 patients from groups B and C. Further significant improvements had occurred in group A patients only, notably relative to muscle strength and reduction of walking aids. It is concluded from our data that inpatient early rehabilitation will achieve the greatest effect and will substantially reduce the recovery phase with its mobility limitations and daily living handicaps.