Effectiveness of a bandage to prevent re-dislocation after total hip arthroplasty in patients with a previous hip dislocation. A randomized controlled trial with 12-week follow-up

Abstract

Objective

To investigate if using a hip bandage is more effective than standard care in the prevention of total hip arthroplasty re-dislocation in patients with a previous total hip arthroplasty dislocation.

Design

randomized controlled trial

Setting

Holstebro Regional Hospital and Viborg Regional Hospital

Subjects

A total of 99 patients, 51 women, mean 70.7 (SD 9.9) years were enrolled in an un-blinded, clinical randomized controlled trial.

Interventions

Participants with at least one previous total hip arthroplasty dislocation were randomized to either wearing a bandage reducing flexion, adduction, and internal rotation of the hip (intervention group) or to standard care (control group). The participants were followed for 12 weeks. Main follow-up measures were as follows: number of re-dislocations (primary outcome), hip disability measured with the Oxford Hip Score (0–48, 48 best), quality of life measured with the 36-Item Short Form Survey (0–100, 100 best), satisfaction with treatment and serious adverse events. Statistical analyses followed the intention-to-treat principle.

Results

No significant group differences were observed for the primary outcome re-dislocations (9 versus 15, P = 0.143) or for disability (11.3 versus 14.4, P = 0.161), quality of life (57.7 versus 48.3, P = 0.050) or satisfaction with treatment (P = 0.562). There were 3 serious adverse events leading to total hip arthroplasty revision in the intervention group and 4 in the control group.

Conclusion

We found that a hip bandage is not superior to standard care in the prevention of total hip arthroplasty re-dislocation in those with a previous total hip arthroplasty dislocation.

Keywords

Hip dislocation hip replacement mobilization restrictions multidisciplinary care

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References

Phillips

Barrett

Losina

, et al. Incidence rates of dislocation, pulmonary embolism, and deep infection during the first six months after elective total hip replacement. J Bone Joint Surg Am 2003; 85: 20–26.

Jolles

Bogoch

. Posterior versus lateral surgical approach for total hip arthroplasty in adults with osteoarthritis. Cochrane Database Syst Rev 2004; :Cd003828.

Bourne

Mehin

. The dislocating hip: what to do, what to do. J Arthroplasty 2004;19:111–114.

Malkani

Ong

Lau

, et al. Early- and late-term dislocation risk after primary hip arthroplasty in the medicare population. J Arthroplasty 2010; 25: 21–25.

Lachiewicz

Soileau

. Low early and late dislocation rates with 36- and 40-mm heads in patients at high risk for dislocation. Clin Orthop Relat Res 2013; 471: 439–443.

Woo

Morrey

. Dislocations after total hip arthroplasty. J Bone Joint Surg Am 1982; 64: 1295–1306.

Dargel

Oppermann

Brüggemann

, et al. Dislocation following total hip replacement. Dtsch Arztebl Int 2014; 111: 884–890.

Gwam

Mistry

Mohamed

, et al. Current epidemiology of revision total Hip arthroplasty in the United States: national inpatient sample 2009 to 2013. J Arthroplasty 2017; 32: 2088–2092.

Mikkelsen

Petersen

Søballe

, et al. Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement? A non-randomized, controlled study. Eur J Phys Rehabil Med 2014; 50: 383–393.

10.

Høgh

Dremstrup

Jensen

, et al. Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture. Strategies Trauma Limb Reconstr 2008; 3: 65–70.

11.

Kristensen

Bandholm

Foss

, et al. High inter-tester reliability of the new mobility score in patients with hip fracture. J Rehabil Med 2008; 40: 589–591.

12.

Parker

Palmer

. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br 1993; 75: 797–798.

13.

Danish Health Authority. National clinical guideline on hip osteoarthritis - non-surgical treatment and rehabilitation following total hip arthroplasty. 2nd edn, Copenhagen: Danish Health Authority, 2021.

14.

Dawson

Fitzpatrick

Carr

, et al. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg Br 1996; 78: 185–190.

15.

Harris

Dawson

Gibbons

, et al. Systematic review of measurement properties of patient-reported outcome measures used in patients undergoing hip and knee arthroplasty. Patient Relat Outcome Meas 2016; 7: 101–108.

16.

Paulsen

Odgaard

Overgaard

. Translation, cross-cultural adaptation and validation of the danish version of the Oxford hip score: assessed against generic and disease-specific questionnaires. Bone Joint Res 2012; 1: 225–233.

17.

Bjorner

Thunedborg

Kristensen

, et al. The danish SF-36 health survey: translation and preliminary validity studies. J Clin Epidemiol 1998; 51: 991–999.

18.

McNaught

Davidson

Ewen

, et al. Patient compliance with hip precautions 12 weeks following primary elective total hip arthroplasty. Arch Orthop Trauma Surg 2021.

19.

Lewinnek

Lewis

Tarr

, et al. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978; 60: 217–220.

20.

Crompton

Osagie-Clouard

Patel

. Do hip precautions after posterior-approach total hip arthroplasty affect dislocation rates? A systematic review of 7 studies with 6,900 patients. Acta Orthop 2020; 91: 687–692.