Article

A systematic literature review and meta-analysis on the effectiveness
of lifestyle restrictions and precautions to prevent dislocation after total hip
arthroplasty. DATA SOURCES: MEDLINE and the Cochrane Library were searched in
February 2015, with additional hand searching of systematic reviews and reference lists. REVIEW METHODS:
This review was conducted in accordance with the PRISMA
statement for reporting systematic reviews and meta-analysis. PubMed and the
Cochrane Library were searched from their start date through to February 2015.
Randomized controlled trials and comparative case series in English, Dutch or
German language were included. Only primary total hip arthroplasty procedures
managed with different postoperative restrictions and precautions protocols were
included. Primary outcome was the total hip arthroplasty dislocation rate,
secondary outcomes were patient functioning, return to activities of daily living
and patient satisfaction. RESULTS: A total of 119 eligible articles were
identified, six were included: three randomized controlled trials, one
retrospective matched cohort study, one retrospective and one prospective cohort
study, describing 1122 procedures (restrictions group: n = 528; no restrictions
group: n = 594). Both the standard posterior and anterolateral surgical
approaches were included. There were eight dislocations (1.5%) in the restricted
group, vs. six dislocations (1.0%) in the unrestricted group. Patients in the
unrestricted group resumed activities significantly faster and were more
satisfied with their pace of recovery. CONCLUSION: A more liberal lifestyle
restrictions and precautions protocol will not lead to worse dislocation rates
after total hip arthroplasty, but will lead to earlier and better resumption of
activities and higher patient satisfaction. These results appear to hold up for
various surgical approaches.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS