Variation in Use of Postoperative Precautions and Equipment Following Total Hip Arthroplasty: A Survey of the AAHKS and CAS Membership

J Arthroplasty. 2018 Oct;33(10):3201-3205. doi: 10.1016/j.arth.2018.05.043. Epub 2018 Jun 6.


Background: A traditional method to reduce dislocation risk following total hip arthroplasty involves prescribing postoperative precautions and ambulatory equipment to patients. The purpose of this study was to determine the prevalence of postoperative precaution and equipment use among North American arthroplasty surgeons for patients undergoing primary total hip arthroplasty.

Methods: We conducted a survey of American Association of Hip and Knee Surgeons and Canadian Arthroplasty Society members using an electronic questionnaire format to determine how often precautions and equipment were prescribed, and whether their use was associated with surgical approach and other surgeon demographics.

Results: Of the respondents, 44% universally prescribed precautions while 33% never prescribed precautions. Use of the posterolateral approach, surgeon experience, and larger head size use were significantly associated (P < .01) with precaution and equipment use. Direct anterior approach surgeons were significantly less likely to prescribe precautions (P < .0001) and significantly less likely to prescribe equipment (P < .0001).

Conclusion: Although postoperative precautions continue to be used to some degree by the majority of members, their consumption of healthcare resources through utilization of additional care providers and purchasing of equipment, known association with reduced patient satisfaction, and lack of supporting evidence make them a target for future scrutiny.

Keywords: direct anterior approach; hip dislocation; hip instability; posterolateral approach; postoperative precautions; total hip arthroplasty.

MeSH terms

  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip / rehabilitation*
  • Canada
  • Female
  • Health Care Surveys
  • Hip Dislocation / etiology
  • Hip Dislocation / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Physical Therapy Modalities
  • Postoperative Care / instrumentation
  • Postoperative Care / methods*
  • United States