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

Purpose: To evaluate the effect of hip precautions following total hip replacement (THR) by comparing outcomes of patients who received hip precautions with those who did not. Methods: Before (phase 1) and after (phase 2) study with two consecutive cohorts of patients. In phase 1, patients were strictly educated about hip precautions. In phase 2, patients were not advised about precautions but encouraged to move as able. The primary outcome was the Oxford Hip Score (measuring pain and function) at three months. Secondary outcomes included Oxford Hip Score, activities of daily living (ADLs) (Nottingham Extended Activities of Daily Living), sleep (Pittsburgh Sleep Quality Index), mood (Hospital Anxiety and Depression Scale), and quality of life (QoL) (EQ-5 D). Results: A total 237 participants successfully underwent THR surgery, 118 participants in phase 1 and 119 in phase 2. At three months postoperatively, participants had significantly equivalent Oxford Hip Scores (MD= -0.82, 95% CI: -2.64 to 1.00). No significant differences between the groups were observed at six weeks and three months postoperatively for secondary outcomes. Conclusions: Patients recovered at a similar rate regardless of whether they received hip precautions or not, with no increase in complications observed. The findings lend evidence to support decision-making around the removal of precautions.