Evidence based rehabilitation after hip arthroplasty

Abstract

Background: Hip arthroplasty is considered the treatment of choice to improve the quality of life of patients affected by degenerative arthritis. The post-op rehabilitation regimen, however, is still a matter of debate. The goal of this study was to perform a systematic review of the available best evidence to provide recommendations for rehabilitation after hip arthroplasty. Materials and methods: Biomedical databases were accessed to identify guidelines, systematic reviews and randomised controlled trials addressing rehabilitation after hip arthroplasty published between 2004 and 2019. Studies were selected and extracted by two independent evaluators with standardised tools. Results: 1 guideline, 8 systematic reviews and 5 randomised controlled trials were included. All included papers were organised according the available evidence of clinical course chronology both in pre- and post-operation rehabilitation up to 6 weeks and thereafter. Although the value of a rehabilitation program after hip arthroplasty is universally recognised, the exact timing and number of sessions is still unknown. A solid literature review allows us to partially answer to this question. Conclusions: Evidence-based rehabilitation recommendations are proposed according to literature research findings. Clinical practice is still somewhat dependent on dogma and traditions, highlighting the need for additional high-quality clinical studies to address areas of uncertainty.

The Recovery of Weight-Bearing Symmetry After Total Hip Arthroplasty Is Activity-Dependent

“…No further improvements were observed at V4 for all ADLs. The crucial time between V2 and V3 can be referred to as the postoperative acute phase of post-THA rehabilitation ( Colibazzi et al, 2020 ). At this time, increased and more symmetrically distributed loads may lead to better performance of ADLs, reduce the risk of falls, and decrease mobility disability ( Monticone et al, 2014 ).…”

A Pessoa Submetida a Artroplastia Total Da Anca Por Coxartrose

“…Os principais objetivos do tratamento cirúrgico e da intervenção do EEER prendem-se ao alívio da dor e à melhoria da capacidade funcional e qualidade de vida, o que promove consequentemente a mobilidade articular e evita a redução da massa muscular (4) .…”

“…O fenómeno do envelhecimento provoca modificações biológicas, tais como a osteoporose, que se evidencia principalmente nas mulheres como um problema que afeta a independência funcional (3) . Cerca de 3-6% da população europeia sofre de sintomas relacionados com a degeneração osteoarticular, dados estes que irão aumentar no futuro devido ao envelhecimento populacional (4) . Quando a dor e o sofrimento sentido pela pessoa expressam limitações que a impedem de desempenhar as suas atividades de vida diária, pode ser proposta a artroplastia total da anca, na qual se implanta uma prótese na diáfise femoral, constituída por cabeça, colo e extremidade (componente femoral), e outra no osso ilíaco (componente acetabular) (3) .…”

“…Assim, a artroplastia destaca-se com o tratamento de eleição nos estadios finais da osteoartrite da anca, sendo que existem vários estudos que mostram o impacto negativo na qualidade de vida destas pessoas. Contudo, ainda que seja dado valor à reabilitação pós-operatória, pouco se sabe acerca da eficácia dos exercícios atendendo ao tipo, frequência, intensidade e duração do programa de reabilitação (4) .…”

Measurement properties of New Mobility Score to evaluate functional recovery in the elderly following total hip arthroplasty

“…Total hip arthroplasty (THA) is the most commonly performed surgical procedure undertaken to relieve pain and restore function in elderly people with end-stage hip osteoarthritis [1]. With the projected increase in the number of the elderly undergoing THA over the next two decades, it becomes even more critical to develop effective rehabilitation strategies, individually adapted, which can contribute most benefit.…”