Rehabilitation for Total Hip Arthroplasty: A Systematic Review.

ABSTRACT: We sought to determine the comparative benefits and harms of rehabilitation interventions for patients who have undergone elective, unilateral THA surgery for the treatment of primary osteoarthritis. We searched PubMed, Embase, The Cochrane Register of Clinical Trials, CINAHL, PsycINFO, Scopus, and ClinicalTrials.gov from January 1, 2005 through May 3, 2021. We included randomized controlled trials and adequately-adjusted nonrandomized comparative studies of rehabilitation programs reporting performance-based, patient-reported, or healthcare utilization outcomes. Three researchers extracted study data and assessed risk of bias, verified by an independent researcher. Experts in rehabilitation content and complex interventions independently coded rehabilitation interventions. The team assessed strength of evidence (SoE). Large heterogeneity across evaluated rehabilitation programs limited conclusions. Evidence from 15 studies suggests diverse rehabilitation programs may not differ in terms of risk of harm or outcomes of pain, strength, activities of daily living, or quality of life (all low SoE). Evidence is insufficient for other outcomes. In conclusion, no differences in outcomes were found between different rehabilitation programs following THA. Further evidence is needed to inform decisions on what attributes of rehabilitation programs are most effective for various outcomes.