Document Detail


Influence of preoperative patient education on the risk of dislocation after primary total hip arthroplasty.
MedLine Citation:
PMID:  19333972     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Anne Lübbeke; Domizio Suvà; Thomas Perneger; Pierre Hoffmeyer
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis and rheumatism     Volume:  61     ISSN:  0004-3591     ISO Abbreviation:  Arthritis Rheum.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-07     Completed Date:  2009-05-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370605     Medline TA:  Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  552-8     Citation Subset:  AIM; IM    
Affiliation:
Geneva University Hospitals, Geneva, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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