Article

Objective: To identify if a tailored rehabilitation programme is more effective
than standard practice at improving function in patients undergoing
metal-on-metal hip resurfacing arthroplasty. Design: Randomized controlled trial.
Setting: Specialist orthopaedic hospital. Subjects: 80 men with a median age of 56 years. Interventions: Tailored post-operative physiotherapy programme compared
with standard physiotherapy. Main Outcomes: Primary outcome - Oxford Hip Score
(OHS), Secondary outcomes: Hip disability and Osteoarthritis Outcome Score
(HOOS), EuroQol (EQ-5D-3L) and UCLA activity score. Hip range of motion, hip
muscle strength and patient selected goals were also assessed. Results: At one
year the mean (SD) Oxford Hip Score of the intervention group was higher, 45.1
(5.3), than the control group, 39.6 (8.8). This was supported by a linear
regression model, which detected a 5.8 unit change in Oxford Hip Score (p <
0.001), effect size 0.76. There was a statistically significant increase in Hip
disability and Osteoarthritis Outcome Score of 12.4% (p < 0.0005), effect size
0.76; UCLA activity score differed by 0.66 points (p < 0.019), effect size 0.43;
EQ 5D showed an improvement of 0.85 (p < 0.0005), effect size 0.76. A total of
80% (32 of 40) of the intervention group fully met their self-selected goal
compared with 55% (22 of 40) of the control group. Hip range of motion increased
significantly; hip flexion by a mean difference 17.9 degrees (p < 0.0005), hip
extension by 5.7 degrees (p < 0.004) and abduction by 4 degrees (p < 0.05).
Muscle strength improved more in the intervention group but was not statistically
significant. Conclusions: A tailored physiotherapy programme improved
self-reported functional outcomes and hip range of motion in patients undergoing
hip resurfacing.

Langue : ANGLAIS