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Evaluation of hip precautions following total hip replacement: a before and after study

Lightfoot, Courtney J.; Sehat, Khosrow R.; Coole, Carol; Drury, Gary; Ablewhite, Joanne; Drummond, Avril E. R.


Courtney J. Lightfoot

Khosrow R. Sehat

Carol Coole

Gary Drury

Professor of Healthcare Research


To evaluate the effect of hip precautions following total hip replacement by comparing outcomes of patients who received hip precautions with those who did not.

Before (phase 1) and after (phase 2) study with two consecutive cohorts of patients. In phase 1, patients were strictly educated about hip precautions. In phase 2, patients were not advised about precautions but encouraged to move as able. The primary outcome was the Oxford Hip Score (measuring pain and function) at three months. Secondary outcomes included Oxford Hip Score, activities of daily living (Nottingham Extended Activities of Daily Living), sleep (Pittsburgh Sleep Quality Index), mood (Hospital Anxiety and Depression Scale), and quality of life (EQ-5 D).

237 participants successfully underwent total hip replacement surgery, 118 participants in phase 1 and 119 in phase 2. At three months postoperatively, participants had significantly equivalent Oxford Hip Scores (MD= -0.82, 95%CI: -2.64 to 1.00). No significant differences between the groups were observed at six weeks and three months postoperatively for secondary outcomes.

Patients recovered at a similar rate regardless of whether they received hip precautions or not, with no increase in complications observed. The findings lend evidence to support decision-making around the removal of precautions.


Sehat, K. R., Lightfoot, C. J., Sehat, K., Coole, C., Drury, G., Ablewhite, J., & Drummond, A. E. R. (2020). Evaluation of hip precautions following total hip replacement: a before and after study. Disability and Rehabilitation, 1-8.

Journal Article Type Article
Acceptance Date Jan 22, 2020
Online Publication Date Feb 23, 2020
Publication Date Feb 23, 2020
Deposit Date Jan 24, 2020
Publicly Available Date Feb 24, 2021
Journal Disability and Rehabilitation
Print ISSN 0963-8288
Electronic ISSN 1464-5165
Publisher Taylor & Francis Open
Peer Reviewed Peer Reviewed
Pages 1-8
Keywords Rehabilitation
Public URL
Additional Information Peer Review Statement: The publishing and review policy for this title is described in its Aims & Scope.; Aim & Scope: http://www.tandfonline....ope&journalCode=idre20; Received: 2019-07-14; Revised: 2020-01-22; Accepted: 2020-01-22; Published: 2020-02-23