Clinical Practice Guideline for Postoperative Rehabilitation in Older Patients With Hip Fractures

Min, Kyunghoon; Beom, Jaewon; Kim, Bo Ryun; Lee, Sang Yoon; Lee, Goo Joo; Lee, Jung Hwan; Lee, Seung Yeol; Won, Sun Jae; Ahn, Sangwoo; Bang, Heui Je; Cha, Yonghan; Chang, Min Cheol; Choi, Jung Yeon; Geol, Jong; Hee, Kyung; Han, Joung-Ho; Jang, Il‐Young; Jin, Youri; Kim, Dong Hwan; Kim, Du Hwan; Kim, In Jong; Kim, Myung Chul; Kim, Won; Lee, Yun Jung; Lee, In Seok; Lee, In Sik; Lee, Jungsoo; Lee, Chang Hyung; Lim, Seong Hoon; Park, Donghwi; Park, Jung Hyun; Park, Myungsook; Park, Yongsoon; Ryu, Ju Seok; Song, Young Jin; Yang, Seoyon; Yang, Hee Seung; Yoo, Jin Soung; Yoo, Jun Il; Yoo, Seung Don; Choi, Kyoung Hyo; Lim, Jae Young

doi:10.5535/arm.21110

Cited by 45 publications

(35 citation statements)

References 166 publications

(213 reference statements)

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“…Standard guidelines have additionally been established based upon recommendations from academic societies. The Korean academy of rehabilitation medicine released a clinical practice guideline for hip fracture rehabilitation [34] and KSBMR released a FLS guidebook [35] . KSBMR has developed a coordinator training program, conducted educational symposia, and offered training sessions every year since 2018 [36] …”

Section: Koreamentioning

confidence: 99%

Fragility Fracture Systems: International Perspectives - Asia & Australia

Tarrant

Kim

Matsushita

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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Background: The incidence and burden of fragility fractures have reached the level where comprehensive systematic care is warranted to optimize the care of these patients. Hip fractures are the most frequently lethal and independence level changing fragility fractures, responsible for 30-day mortality comparable to high-energy trauma patients with injury severity scores over 12. It is a reasonable expectation that countries have a hip fracture treating system of care in place for this high-risk population. This review explores the systems of care from the Asia-Pacific Perspective.Methods: From the International Orthopaedic Trauma Association's member societies, nations from the Asia-Pacific Region were requested to contribute with an overview of their fragility fracture management systems. The content or the review was standardized by a template of headings, which each country endeavored to cover.Results: Australia, Japan, and South Korea contributed voluntarily from the 5 member countries of the region. Each country has made considerable efforts and achievements with diverse approaches to standardize and improve the care of fragility fractures, particularly hip fractures. Beyond the individual nations' efforts there is also an existing Asia-Pacific Collaborative. The data collection and in some counties the existence of a registry is promising; funding and recognition of the problem among competing health care budget priorities are common.Conclusions: Our review covers some of the countries with strongest economy and highest health care standards. The lack of a universal robust system for hip fracture care is apparent. The data collection from registry initiations is expected to drive system development further in these countries and hopefully fast track the development in other countries within the most populous geographical region of the Earth.

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Section: Koreamentioning

confidence: 99%

Fragility Fracture Systems: International Perspectives - Asia & Australia

Tarrant

Kim

Matsushita

et al. 2022

OTA International: The Open Access Journal of Orthopaedic Trauma

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“…From 2019, the clinical practice guideline for postoperative rehabilitation after hip fracture in older patients with hip fractures was developed based on the level of evidence of relevant literature and the consensus of multidisciplinary experts. This guideline was published in 2021 and presented comprehensive recommendations for the rehabilitation of adult patients after hip fracture surgery [ 98 ].…”

Section: Global Regional National and Local Quality Improvement Initi...mentioning

confidence: 99%

Quality improvement initiatives in the care and prevention of fragility fractures in the Asia Pacific region

Mitchell

Ang²,

Mercado-Asis³

et al. 2022

Arch Osteoporos

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Summary This narrative review summarises ongoing challenges and progress in the care and prevention of fragility fractures across the Asia Pacific region since mid-2019. The approaches taken could inform development of national bone health improvement Road Maps to be implemented at scale during the United Nations ‘Decade of Healthy Ageing’. Purpose This narrative review summarises recent studies that characterise the burden of fragility fractures, current care gaps and quality improvement initiatives intended to improve the care and prevention of fragility fractures across the Asia Pacific region. Methods The review focuses on published studies, reports and quality improvement initiatives undertaken during the period July 2019 to May 2022. Results Epidemiological studies conducted in countries and regions throughout Asia Pacific highlight the current and projected increasing burden of fragility fractures. Recent studies and reports document a persistent and pervasive post-fracture care gap among people who have sustained fragility fractures. Global initiatives developed by the Fragility Fracture Network and International Osteoporosis Foundation have gained significant momentum in the Asia Pacific region, despite the disruption caused by the COVID-pandemic. The Asia Pacific Fragility Fracture Alliance has developed educational resources including a Hip Fracture Registry Toolbox and a Primary Care Physician Education Toolkit. The Asia Pacific Osteoporosis and Fragility Fractures Society—a new section of the Asia Pacific Orthopaedic Association—is working to engage orthopaedic surgeons across the region in the care and prevention of fragility fractures. The Asia Pacific Consortium on Osteoporosis developed a framework to support national clinical guidelines development groups. Considerable activity at the national level is evident in many countries across the region. Conclusion Development and implementation of national Road Maps informed by the findings of this review are urgently required to respond to the epidemiological emergency posed by fragility fractures during the United Nations ‘Decade of Healthy Ageing’.

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“…Surgical intervention of the hip joint is frequently used in adolescents with congenital hip dysplasia, adults and elderly patients requiring arthroscopy or joint replacement surgeries (1). Early physiotherapy and rehabilitation after hip surgery are highly beneficial, and early mobilization is known to improve outcomes (2,3). However, post-operative pain is an important limiting factor that can slow down the rehabilitation process.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Quadratus Lumborum Block for Pain Control in Patients Undergoing Hip Surgeries: A Systematic Review and Meta-Analysis

Wei

Huang

et al. 2022

Front. Med.

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BackgroundSeveral studies have reported the use of anterior, posterior and lateral quadratus lumborum block (QLB) for pain control in hip surgeries. However, high-quality evidence is lacking. The current review aimed to summarize data on the efficacy of QLB for pain control in patients undergoing hip surgeries.MethodsPubMed, Embase, and Google Scholar databases were searched up to August 5, 2021 for randomized controlled trials (RCTs) or non-RCTs assessing the efficacy of QLB for any type of hip surgery.ResultsThirteen studies were included (nine RCTs and four non-RCTs). On pooled analysis, there was a statistically significant reduction of 24-h total opioid consumption in patients receiving QLB as compared to the control group (MD: −9.92, 95% CI: −16.35, −3.48 I2 = 99% p = 0.003). We noted a statistically significant reduction of pain scores in the QLB group as compared to control group at 2–4 h (MD: −0.57, 95% CI: −0.98, −0.17 I2 = 61% p = 0.005), 6–8 h (MD: −1.45, 95% CI: −2.09, −0.81 I2 = 86% p < 0.00001), 12 h (MD: −1.12, 95% CI: −1.89, −0.34 I2 = 93% p = 0.005), 24 h (MD: −0.71, 95% CI: −1.27, −0.15 I2 = 89% p = 0.01) and 48 h (MD: −0.76, 95% CI: −1.37, −0.16 I2 = 85% p = 0.01) after the procedure. There was a statistically significant reduction in the risk of nausea/vomiting (RR: 0.40, 95% CI: 0.18, 0.88 I2 = 62% p = 0.02) in patients receiving QLB but no difference in the risk of pruritis (RR: 0.46, 95% CI: 0.17, 1.24 I2 = 16% p = 0.13) and urinary retention (RR: 0.44, 95% CI: 0.19, 1.02 I2 = 0% p = 0.06).ConclusionQLB as a part of a multimodal analgesic regimen reduces opioid consumption and pain scores in patients undergoing hip surgeries. The certainty of evidence based on GRADE was moderate. Despite the statistically significant results, the clinical relevance of the analgesic efficacy of QLB is debatable due to the small effect size.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42021267861.

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Clinical Practice Guideline for Postoperative Rehabilitation in Older Patients With Hip Fractures

Cited by 45 publications

References 166 publications

Fragility Fracture Systems: International Perspectives - Asia & Australia

Fragility Fracture Systems: International Perspectives - Asia & Australia

Quality improvement initiatives in the care and prevention of fragility fractures in the Asia Pacific region

Efficacy of Quadratus Lumborum Block for Pain Control in Patients Undergoing Hip Surgeries: A Systematic Review and Meta-Analysis

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