Document Detail


Partial versus unrestricted weight bearing after an uncemented femoral stem in total hip arthroplasty: recommendation of a concise rehabilitation protocol from a systematic review of the literature.
MedLine Citation:
PMID:  20012073     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this systematic review was to find evidence-based support in the literature to allow immediate unrestricted weight bearing after primary uncemented total hip arthroplasty (THA). Accelerated rehabilitation programs for THA are becoming increasingly popular to shorten hospital stay and to facilitate rapid restoration of function. The goals of these rehabilitation programs could be more easily achieved if immediate unrestricted weight bearing (UWB) could be allowed after a THA. So far, however, immediate weight bearing is frequently contraindicated in widely accepted protocols for uncemented THA due to fear for subsidence and absence of osseous integration of the femoral stem. Thus, frequently protected weight bearing and restricted activities are still advocated for at least 6 weeks after surgery. In addition, we analyzed the literature to come to a recommendation on gait pattern and walking aid. From a systematic search in several electronic databases 13 studies met the inclusion criteria. These studies were reviewed according to the Cochrane methodology. We found moderate to strong evidence that no adverse effects on subsidence and osseous integration of the femoral stem after uncemented THA occur after immediate UWB. Based on this literature review, we recommend early rehabilitation after uncemented THA with a reciprocally gait pattern using crutches, one cane for independency in ADL in case patients walk limp-free and walking without crutches as soon as possible. During the first weeks after surgery only stair climbing should be performed with protected weight bearing because of high torsion loads on the hip.
Authors:
A M Hol; S van Grinsven; C Lucas; J L C van Susante; C J M van Loon
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Publication Detail:
Type:  Comparative Study; Journal Article; Review     Date:  2009-12-10
Journal Detail:
Title:  Archives of orthopaedic and trauma surgery     Volume:  130     ISSN:  1434-3916     ISO Abbreviation:  Arch Orthop Trauma Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-02-23     Completed Date:  2010-05-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011043     Medline TA:  Arch Orthop Trauma Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  547-55     Citation Subset:  IM    
Affiliation:
Department of Physiotherapy, Rijnstate Hospital, Arnhem, The Netherlands. ahol@Alysis.nl
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MeSH Terms
Descriptor/Qualifier:
Arthroplasty, Replacement, Hip / rehabilitation*
Bone Cements
Hip Prosthesis
Humans
Osteoarthritis, Hip / surgery*
Recovery of Function
Weight-Bearing*
Chemical
Reg. No./Substance:
0/Bone Cements

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


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