Literature DB >> 19333972

Influence of preoperative patient education on the risk of dislocation after primary total hip arthroplasty.

Anne Lübbeke1, Domizio Suvà, Thomas Perneger, Pierre Hoffmeyer.   

Abstract

OBJECTIVE: Dislocation is a well-known complication after total hip arthroplasty (THA), and is the second-highest cause of revision surgery. Our objective was to assess the effect of preoperative patient education on the occurrence of hip dislocation within 6 months after primary THA.
METHODS: Between 1998 and 2007, we conducted a prospective cohort study at the Geneva University Hospital Department of Orthopaedic Surgery, including all primary THAs performed via an anterolateral transgluteal approach with the use of a 28-mm diameter head. The preoperative education session was introduced in June 2002 and included advice on muscle strengthening exercises and postoperative restrictions of range of motion as a means of preventing dislocation. The main outcome was the incidence of dislocation within 6 months of surgery.
RESULTS: A total of 597 patients who underwent 656 THAs between June 2002 and June 2007 participated in the education session, whereas 1,641 patients who underwent 1,945 procedures did not. Forty-six dislocations occurred over the study period, 5 (0.8%) in participants and 41 (2.1%) in nonparticipants (absolute risk reduction 1.3%; 95% confidence interval [95% CI] 0.4, 2.3), with the time interval between surgery and dislocation being significantly shorter among participants (0.2 versus 1.2 months). Nonparticipants had a 2.8 times higher risk of dislocation than participants (unadjusted odds ratio [OR] 2.80; 95% CI 1.10, 7.13). Adjustment for age, sex, comorbidities, and prior surgery did not change the results (adjusted OR 2.79; 95% CI 1.09, 7.15).
CONCLUSION: Our findings suggest that participation in a preoperative patient education session may reduce the risk of dislocation within 6 months after THA.

Entities:  

Mesh:

Year:  2009        PMID: 19333972     DOI: 10.1002/art.24340

Source DB:  PubMed          Journal:  Arthritis Rheum        ISSN: 0004-3591


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