March 13 (UPI) — People who’ve undergone hip replacement surgery may have one less thing to worry about, a new study says.
Most low-risk total hip replacement patients can ditch the uncomfortable post-surgical recovery safeguards often recommended by doctors, according to new research presented this week at the annual meeting of the American Academy of Orthopedic Surgeons.
“The majority of patients we see are low risk; 90 percent of patients probably qualify for minimized precautions,” Peter Sculco, an orthopedic surgeon at Hospital for Special Surgery and study lead author, said in a news release.
Researchers examined the dislocation rates of past patients who underwent posterior primary uncemented total hip replacements between 2014 to 2016.
Over the last decade, surgeons began using the anterior approach after total hip replacement, which only cautions patients to avoid posing in a flexed external rotation position, like when a person puts on shoes or shaves their legs.
The posterior approach was once the normal post-surgery guidance for hip replacement. It required patients to not to flex their hips past 90 degrees, not to rotate their hips more than 10 degrees internally, to use a raised seat cushion at all times and to sleep on their backs for six weeks.
When the researchers looked at data through six postoperative weeks, they found that patients who followed the anterior approach only had 46 percent dislocation rate compared to a .53 dislocation rate for the posterior group.
“The precautions can be limiting and cause fear in patients,” Sculco said. “Sleeping on your back is very uncomfortable for many people. You often hear from physical therapists that patients are relieved when they can finally cross their legs and sleep on their side.”
Other studies have reported that the posterior approach is the safer, less painful option for healing after hip replacement surgery.
Whichever approach a doctor uses, hip replacements have shown high durability over time. About 89 percent are still in place after 15 years and 70 percent remain intact after 20 years.
By 2030, close to four million total joint arthroplasty procedures, which include hip replacements, are expected to be performed in the United States. So the researchers want to figure out how to avoid pain and discomfort as much as possible.
“Minimizing precautions and simplifying the postoperative recovery is part of the larger simplification of surgery where we are using more selected resources and interventions for people, instead of blanketing everyone with the same kind of protocols,” Sculco said. “In 2010, there were 310,000 hip replacements in the United States and that number is increasing. It’s probably 350,000, if not more, now.”