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01-08-2015 | Original Paper

Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement

Authors: David Jean Biau, Raphael Porcher, Alexandra Roren, Antoine Babinet, Nadia Rosencher, Sylvie Chevret, Serge Poiraudeau, Philippe Anract

Published in: International Orthopaedics | Issue 8/2015

Abstract

Purpose

The purpose of this study was to evaluate pre-operative education versus no education and mini-invasive surgery versus standard surgery to reach complete independence.

Methods

We conducted a four-arm randomized controlled trial of 209 patients. The primary outcome criterion was the time to reach complete functional independence. Secondary outcomes included the operative time, the estimated total blood loss, the pain level, the dose of morphine, and the time to discharge.

Results

There was no significant effect of either education (HR: 1.1; P = 0.77) or mini-invasive surgery (HR: 1.0; 95 %; P = 0.96) on the time to reach complete independence. The mini-invasive surgery group significantly reduced the total estimated blood loss (P = 0.0035) and decreased the dose of morphine necessary for titration in the recovery (P = 0.035).

Conclusions

Neither pre-operative education nor mini-invasive surgery reduces the time to reach complete functional independence. Mini-invasive surgery significantly reduces blood loss and the need for morphine consumption.

Learmonth ID, Young C, Rorabeck C (2007) The operation of the century: total hip replacement. Lancet 370(9597):1508–1519PubMedCrossRef

Haute Autorité de Santé (2007) Evaluation des prothèses de hanche. Saint-Denis La Plaine. www.has-sante.fr/portail/upload/docs/application/pdf/rapport_evaluation_des_protheses_de_hanche.pdf. Accessed 30 March 2015

Berry DJ, Harmsen WS, Cabanela ME, Morrey BF (2002) Twenty-five-year survivorship of two thousand consecutive primary Charnley total hip replacements: factors affecting survivorship of acetabular and femoral components. J Bone Joint Surg Am 84-A(2):171–177PubMed

Ibrahim MS, Twaij H, Giebaly DE, Nizam I, Haddad FS (2013) Enhanced recovery in total hip replacement: a clinical review. Bone Joint J 95-B(12):1587–1594PubMedCrossRef

Xu CP, Li X, Song JQ, Cui Z, Yu B (2013) Mini-incision versus standard incision total hip arthroplasty regarding surgical outcomes: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE 8(11):e80021PubMedCentralPubMedCrossRef

McDonald S, Page MJ, Beringer K, Wasiak J, Sprowson A (2014) Preoperative education for hip or knee replacement. Cochrane Database Syst Rev 5:CD003526PubMed

Huddleston JI, Wang Y, Uquillas C, Herndon JH, Maloney WJ (2012) Age and obesity are risk factors for adverse events after total hip arthroplasty. Clin Orthop Relat Res 470(2):490–496PubMedCentralPubMedCrossRef

Maradit Kremers H, Visscher SL, Kremers WK, Naessens JM, Lewallen DG (2014) Obesity increases length of stay and direct medical costs in total hip arthroplasty. Clin Orthop Relat Res 472(4):1232–1239PubMedCentralPubMedCrossRef

Vasarhelyi EM, MacDonald SJ (2012) The influence of obesity on total joint arthroplasty. J Bone Joint Surg (Br) 94(11 Suppl A):100–102CrossRef

10.

Nezry N, Jeanrot C, Vinh TS, Ganz R, Tomeno B, Anract P (2000) Partial anterior trochanteric osteotomy in total hip arthroplasty: surgical technique and preliminary results of 127 cases. J Arthroplasty 18(3):333–337CrossRef

11.

Gross JB (1983) Estimating allowable blood loss: corrected for dilution. Anesthesiology 58(3):277–280PubMedCrossRef

12.

Schoenfeld DA (1983) Sample-size formula for the proportional-hazards regression model. Biometrics 39(2):499–503PubMedCrossRef

13.

Gail M, Simon R (1985) Testing for qualitative interactions between treatment effects and patient subsets. Biometrics 41(2):361–372PubMedCrossRef

14.

Crowe J, Henderson J (2003) Pre-arthroplasty rehabilitation is effective in reducing hospital stay. Can J Occup Ther 70(2):88–96PubMedCrossRef

15.

Gocen Z, Sen A, Unver B, Karatosun V, Gunal I (2004) The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial. Clin Rehabil 18(4):353–358PubMedCrossRef

16.

Vukomanovi A, Popovi Z, Durovi A, Krsti L (2008) The effects of short-termp reoperative physical therapy and education on early functional recovery of patients younger than 70 undergoing total hip arthroplasty. Vojnosanit Pregl 65(4):291–297CrossRef

17.

Giraudet-Le Quintrec JS, Coste J, Vastel L, Pacault V, Jeanne L, Lamas JP, Kerboull L, Fougeray M, Conseiller C, Kahan A, Courpied JP (2003) Positive effect of patient education for hip surgery: a randomized trial. Clin Orthop Relat Res 414:112–120PubMedCrossRef

18.

Sherry E, Egan M, Henderson A, Warnke PH (2002) Minimally invasive techniques for total hip arthroplasty. J Bone Joint Surg Am 84-A(8):1481, author reply 1481–2PubMed

19.

Chimento GF, Pavone V, Sharrock N, Kahn B, Cahill J, Sculco TP (2005) Minimally invasive total hip arthroplasty. A prospective randomized study. J Arthroplasty 20(2):139–144PubMedCrossRef

20.

Musil D, Stehlík J, Verner M (2008) A comparison of operative invasiveness in minimally invasive anterolateral hip replacement (MIS-AL) and standard hip procedure, using biochemical markers. Acta Chir Orthop Traumatol Cech 75(1):16–20PubMed

Title: Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement
Authors: David Jean Biau
Raphael Porcher
Alexandra Roren
Antoine Babinet
Nadia Rosencher
Sylvie Chevret
Serge Poiraudeau
Philippe Anract
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 8/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-015-2802-y

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Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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