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Abstract
BackgroundTotal hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). Historically, people following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. The purpose of this study was to determine current practices in the provision of these interventions in the UK for people following primary THR.MethodsA 27-question, self-administered online survey was developed and distributed to UK physiotherapists and occupational therapists involved in the management of people following primary THR (target respondents). The survey included questions regarding the current practices in the provision of equipment and hip precautions for THR patients, and physiotherapist’s and occupational therapist’s attitudes towards these practices. The survey was disseminated through print and web-based/social media channels.Results170 health professionals (87 physiotherapists and 83 occupational therapists), responded to the survey. Commonly prescribed equipment in respondent’s health trusts were raised toilet seats (95 %), toilet frames and rails (88 %), furniture raises (79 %), helping hands/grabbers (77 %), perching stools (75 %) and long-handled shoe horns (75 %). Hip precautions were routinely prescribed by 97 % of respondents. Hip precautions were most frequently taught in a pre-operative group (52 % of respondents). Similarly equipment was most frequently provided pre-operatively (61 % respondents), and most commonly by occupational therapists (74 % respondents). There was variability in the advice provided on the duration of hip precautions and equipment from up to 6 weeks post-operatively to life-time usage.ConclusionsCurrent practice on hip precautions and provision of equipment is not full representative of clinician’s perceptions of best care after THR. Future research is warranted to determine whether and to whom hip precautions and equipment should be prescribed post-THR as opposed to the current ‘blanket’ provision of equipment and movement restriction provided in UK practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1092-x) contains supplementary material, which is available to authorized users.
Highlights
Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK)
Survey A self-administered online survey (through the SurveyMonkey platform) consisting of 27 questions was developed (Additional file 1). This survey was structured to answer the following research questions: (1) what are the current practices of occupational therapists and physiotherapists on the provision of post-operative equipment and hip precaution advice following primary total hip replacement; (2) what are the attitudes of occupational therapists and physiotherapists to these practices; (3) are there any patient groups where these practices are modified or amended due to differences in circumstances or patient characteristics; and (4) what are the attitudes of occupational therapists and physiotherapists towards the conduct of research to assess the use of post-operative equipment and hip precaution advice following primary total hip replacement? The survey provided partial closed-ended questions, requiring a categorical response
Sixty-six percent of respondents felt that there needed to be more research on the provision of equipment, with 88 % recommending more research on the provision of hip precautions following primary THR. The findings of this survey indicate that whilst equipment and hip precautions are routinely provided for the majority of people following primary THR, this is largely questioned by UK occupational therapists and physiotherapists
Summary
Total hip replacement (THR) is one of the most common orthopaedic procedures in the United Kingdom (UK). People following THR have been provided with hip precautions and equipment such as: raised toilet seats and furniture rises, in order to reduce the risks of dislocation post-operation. Patients have been taught standard hip precautions [11, 14] These include: avoiding hip flexion beyond 90°, adduction beyond the mid-line and internal and external rotation greater than 20° [15]. Equipment such as raised toilet seats, long-handled reaching devices, perching stools and chair raises have been provided to prevent patients moving into these positions. These were originally aimed to avoid injuries and to aid the soft tissue repair after surgery
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