en
Scientific article
Review
English

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

Published inArthritis and rheumatism, vol. 61, no. 4, p. 552-558
Publication date2009
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.

Keywords
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip/*adverse effects/methods
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hip Dislocation/*epidemiology/prevention & control/surgery
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • *Patient Education as Topic
  • Preoperative Care/*methods
  • Prospective Studies
  • Reoperation
  • Risk Factors
Citation (ISO format)
LUEBBEKE-WOLFF, Anne et al. Influence of preoperative patient education on the risk of dislocation after primary total hip arthroplasty. In: Arthritis and rheumatism, 2009, vol. 61, n° 4, p. 552–558. doi: 10.1002/art.24340
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ISSN of the journal0004-3591
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