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

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Published in Arthritis and Rheumatism. 2009, vol. 61, no. 4, p. 552-558
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 AgedAged, 80 and overArthroplasty, Replacement, Hip/*adverse effects/methodsCohort StudiesFemaleFollow-Up StudiesHip Dislocation/*epidemiology/prevention & control/surgeryHumansLongitudinal StudiesMaleMiddle Aged*Patient Education as TopicPreoperative Care/*methodsProspective StudiesReoperationRisk Factors
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PMID: 19333972
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Research groups Epidémiologie clinique (115)
Chirurgie orthopédique et traumatologique (98)
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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. https://archive-ouverte.unige.ch/unige:19937

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Deposited on : 2012-04-23

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