Abstract
Background and purpose — It is unclear whether physiotherapy interventions or patient education before total hip replacement (THR) is beneficial for patients postoperatively. Utilizing the Swedish Hip Arthroplasty Register (SHAR), we retrospectively studied the influence of preoperative self-reported exposure to physiotherapy and/or patient education on patient-reported outcomes 1 year after THR.Patients and methods — Data covering all THRs performed in Sweden for osteoarthritis, between the years 2012 and 2015, was obtained from SHAR. There were 30,756 patients with complete data. Multiple linear regression modelling was performed with 1-year postoperative PROMs (hip pain on a visual analogue scale [VAS], with the quality of life measures EQ-5D index and EQ VAS, and surgery satisfaction VAS) as dependent variables. Self-reported physiotherapy and patient education (yes or no) were used as independent variables.Results — Physiotherapy was associated with slightly less pain VAS (–0.7, 95% CI –1.1 to –0.3), better EQ-5D index (0.01, CI 0.00–0.01), EQ VAS (0.8, CI 0.4–1.2), and better satisfaction VAS (–0.7, CI –1.2 to –0.2). Patient education was associated with slightly better EQ-5D index (0.01, CI 0.00–0.01) and EQ VAS (0.7, CI 0.2–1.1).Interpretation — Even though we found statistically significant differences in favor of physiotherapy and patient education, the magnitude of those were too small and inconsistent to conclude a truly positive influence. Further research is needed with more specific and demarcated physiotherapy interventions.
Highlights
It is unclear whether physiotherapy interventions or patient education before total hip replacement (THR) is beneficial for patients postoperatively
Utilizing the Swedish Hip Arthroplasty Register (SHAR), we retrospectively studied the influence of preoperative selfreported exposure to physiotherapy and/or patient education on patient-reported outcomes 1 year after THR
Patients exposed to PT/Supported Osteoarthritis Self-Management Programme (SOASP) had a statistically significantly lower age, BMI, preoperative EuroQol 5 dimensions (EQ-5D) index, and preoperative EQ-VAS, but higher preoperative pain VAS when compared with patients not exposed, on average
Summary
It is unclear whether physiotherapy interventions or patient education before total hip replacement (THR) is beneficial for patients postoperatively. Utilizing the Swedish Hip Arthroplasty Register (SHAR), we retrospectively studied the influence of preoperative selfreported exposure to physiotherapy and/or patient education on patient-reported outcomes 1 year after THR. Physiotherapy, in the form of supervised exercise, has been shown to reduce pain and improve function as assessed with patient-reported outcome measures (PROMs) for hip OA patients (Hernandez-Molina et al 2008, Fransen et al 2014), including later stages of the disease (Rooks et al 2006, Villadsen et al 2014). A recent meta-analysis including 13 RCTs reported a positive effect of preoperative exercise and patient education on postoperative pain for hip OA (Moyer et al 2017). According to data from the Swedish Hip Arthroplasty Register 2015, the proportion of hip OA patients that have visited a physiotherapist (47–89%) or taken part in the SOASP (10–63%) prior
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have