Hip precautions after total hip replacement and their discontinuation from practice: patient perceptions and experiences

• Published in: Disability and rehabilitation 2021-09, Vol.43 (20), p.2890-2896
• Main Authors: Lightfoot, Courtney J., Coole, Carol, Sehat, Khosrow R., Drummond, Avril E. R.
• Format: Article
• Language: English
• Subjects: hip arthroplasty; movement restrictions; Patient experience; patient perspective; rehabilitation; total joint arthroplasty
• ISSN: 0963-8288; 1464-5165
• DOI: 10.1080/09638288.2020.1722262

Hip precautions are routinely provided to reduce the risk of dislocation following total hip replacement despite evidence suggesting they provide no additional benefit and may, actually, impede recovery. Our aim was to report the views of patients who had been recruited into a trial comparing outcomes in participants who were prescribed hip precautions with those who were not. Semi-structured interviews were conducted. Topics explored included experiences and opinions of the service (either hip precautions or no hip precautions), information offered, and equipment provided. Thematic analysis was used to identify and report themes. Six themes were identified: perceived justification, and advantages and disadvantages for the postoperative recovery regime prescribed, perceived risk, and fear of dislocation, adherence to the postoperative regime prescribed, and experiences of adaptive equipment. Participants who received hip precautions had mixed views about their use: some felt they were restrictive whilst others believed they provided reassurance. Participants who did not receive hip precautions were less anxious about dislocating their hip but were unsure how to progress their rehabilitation. The discontinuation of precautions may decrease patients' fears about dislocation but more guidance from rehabilitation staff about how to move safely during recovery is required. Implications for rehabilitation Hip precautions may unnecessarily exacerbate patients' anxieties and fear about dislocation following total hip replacement. Hip precautions impact on patients' recovery both physically and psychologically. Patients should be advised about moving and returning to activities following total hip replacement, whether they receive hip precautions or not.