Evaluation of hip precautions following total hip replacement: a before and after study

Clinicians’ experiences of discontinuing routine hip precautions following total hip replacement surgery: a qualitative analysis

“…The HippityHop trial, a before and after study, was designed around this change and evaluated the discontinuation of hip precautions and implementation of a no hip precautions regime on patient outcomes. HippityHop (n=237) showed that patients who did and did not receive hip precautions recovered at a similar pace, and no differences in clinical outcomes or complications were observed between the groups [5].…”

“…To participate in an interview, participants had to have provided care and treatment to patients during both phases of the HippityHop trial [5]. Interviews were conducted between one and six months after the change in service had occurred.…”

“…Hip precautions protocols are commonly used in UK hospitals, to reduce the risk of dislocation following total hip replacement surgery, despite evidence suggesting that they provide no additional benefit [1][2][3]. Indeed, recent studies have reported that patients recover at a similar rate regardless of whether they receive precautions or not, with no increase in the number of complications observed, including hip dislocation which is the major concern of clinicians [4][5][6]. Although many clinicians are interested in moving away from a regimented regime of hip precautions for all patients [7], there remains uncertainty around how this can be operationalised and achieved in practice.…”

Hip precautions after posterior approach total hip arthroplasty among patients with primary hip osteoarthritis do not influence early recovery: a systematic review and meta-analysis of randomized and non-randomized studies with 8,835 patients

“…The five single-center NRS included 7,219 patients using a non-randomized comparison before and after a procedure change from movement precautions to no or minimal precautions for six 25,53,55,56 or 12 54 weeks (Table 1).…”

“…The meta-analysis including 5 NRS showed a RR of 0.9 (CI 0.3 -2.5) based on 25 dislocations in 2,199 patients (1.1%) in precaution group and 22 dislocations in 1,932 patients (1.1%) in control group. 25,[53][54][55][56] The absolute risk difference was 1 fewer per 1,000 (CI 8 fewer -17 more). A subgroup analysis, comparing the 2 NRS with some precautions in the control group (van der Weegen et al and Mikkelsen et al) showed a RR of 1.8 (CI 0.2 -20.0 compared to RR 0.6 (CI 0.3 -1.5) for the remaining three studies (subgroup difference p-value: 0.4).…”