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Can occupational therapy & specialist equipment help hip replacement recovery?

Total hip replacement is one of the most common orthopaedic procedures in the UK. Historically, people following hip replacement have been provided with hip precautions and equipment such as raised toilet seats and furniture rises, to reduce the risks of dislocation after hip replacement. However, this has been recently questioned with some hospitals opting to change practice and relax these restrictions. Dr Toby Smith (University of East Anglia) led a Cochrane review exploring the evidence around this historic management approach following hip replacement.

The authors found these results particularly fascinating when compared to the current evidence reported in their Cochrane review. They identified three trials including 492 people who had received a hip replacement. The authors reported that there was no benefit of providing equipment or placing movement restriction on patients after hip replacement, and these restrictions did not reduce dislocation events. There was also evidence to suggest that patients may have greater satisfaction to their recovery when hip restrictions and equipment were not enforced. The lead author, Dr Toby Smith (School of Health Sciences) concludes ““based on the Cochrane review, the current practice of providing hip precautions and equipment after hip replacement may not necessarily be benefiting patients”. He continues “we now intend to conduct further research at UEA, Nottingham, Bristol and Kings College London to determine whether and to whom hip precautions and equipment should be prescribed after hip replacement as opposed to the current ‘blanket’ provision of equipment and movement restriction provided in UK practice”.