Background: Posterior hip precautions have been routinely prescribed to decrease dislocation rates. The purpose of this study was to determine if the absence of hip precautions improved early recovery after total hip arthroplasty via the posterolateral approach. METHODS:Patients undergoing total hip arthroplasty via the posterolateral approach at three centers were enrolled. Patients meeting the selection criteria were randomized to Standard Hip Precautions (SHP) or No Hip Precautions (NHP) for six weeks following surgery. HOOS Jr., health state visual analog score, and rate of pain scores were recorded preoperatively and in subsequent postoperative visits; dislocation episodes were also noted. Standard statistical analysis was performed. RESULTS:From 2016-2017, 159 patients were randomized to SHP and 154 patients were randomized to NHP. Controlling for the center at which the surgery was performed, the only difference in outcome scores between the two groups was at two weeks; the NHP group had a lower HOOS Jr. score when compared to the SHP group (p=0.03). There was no difference in outcome scores at any other time points when compared to preoperative assessments. In the SHP group, there were two recorded dislocations (1.3%) and one in the NHP group 0.7% (p=0.62). CONCLUSION:In this multicenter, randomized, controlled study, the absence of hip precautions in the postoperative period did not improve subjective outcomes which may be explained by the

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Delayed diagnosis of jersey finger injuries often results in retraction of the flexor digitorum profundus tendon. Current practice recommends limiting tendon advancement to 1 cm in delayed repairs. The purpose of this study was to investigate the biomechanical consequences of tendon shortening on the force required to form a fist. The flexor digitorum profundus muscle was isolated in ten cadaveric forearms and the force required to form a fist was recorded. Simulated jersey finger injuries to the ring finger were then created and repaired. The forces required to pull the fingertips to the palm after serial tendon advancements were measured. There was a near linear increase in the force required for making a fist with shortening up to 2.5 cm. The force required to make a fist should be taken into account when considering the limit of 'safe' tendon shortening in delayed repair of jersey finger injuries.

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