scholarly journals An eHealth Program for Patients Undergoing a Total Hip Arthroplasty: Protocol for a Randomized Controlled Trial (Preprint)

2017 ◽  
Author(s):  
Rosemary Saunders ◽  
Karla Seaman ◽  
Catherine Ashford ◽  
Trudy Sullivan ◽  
Judith McDowall ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Patient Outcomes ◽  
Hip Arthroplasty ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Care Group ◽  
Total Hip

BACKGROUND Total hip arthroplasty is an effective surgical procedure commonly used worldwide for patients suffering the disabling effects of osteoarthritis when medical therapy is unsuccessful. Traditionally pre- and postoperative information for patients undergoing a hip arthroplasty has been provided by paper-based methods. Electronic health (eHealth) programs to support individualized patient education on preoperative preparation, in-patient care, and home rehabilitation have the potential to increase patient engagement, enhance patient recovery, and reduce potential postoperative complications. OBJECTIVE The aim of this study is to compare the addition of an eHealth program versus standard care for pre- and postoperative education on patient outcomes for primary total hip arthroplasty. METHODS One hundred patients undergoing a primary elective total hip arthroplasty will be recruited from a metropolitan hospital in Western Australia to participate in a 6-month parallel randomized control trial. Participants will be randomized to either the standard care group (n=50) and will be given the education booklet and enrolled to attend a 1-hour education session, or the intervention group (n=50), and will receive the same as the standard care plus access to an eHealth program titled “My Hip Journey.” The eHealth program encourages the patient to log in daily, from 2 weeks prior to surgery to 30 days postsurgery. The information on the platform will be aligned with the patient's individual surgical journey and will include exercises to be completed each day for the duration of the program. The primary outcome measure is the Hip Dysfunction and Osteoarthritis Outcome Score, version LK 2.0. Secondary outcome measures include the EuroQoL EQ-5D-5L, a 5-level 5-dimension quality of life measure, and the Self-Efficacy for Managing Chronic Disease Scale. Data will be collected at pre-admission (presurgery) and at 6 weeks, 3 months, and 6 months postsurgery. A patient satisfaction survey will be completed 6 weeks postsurgery and Web-based analytics will be collected 6 months postsurgery. A cost-effectiveness analysis, using the intention-to-treat principle, will be conducted from the hospital’s perspective. RESULTS Enrollment in the study commenced in January 2018 with recruitment due for completion towards the end of the year. The first results are expected to be submitted for publication in 2019. CONCLUSIONS The outcomes and cost of using an eHealth program to support a patient’s recovery from a hip arthroplasty will be compared with standard care in this study. If the eHealth program is found to be effective, further implementation across clinical practice could lead to improvement in patient outcomes and other surgical areas could be incorporated. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12617001433392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657&isReview=true (Archived by WebCite at http://www.webcitation.org/6yzoTuggx). REGISTERED REPORT IDENTIFIER RR1-10.2196/9654

Correction of pelvic adduction during total hip arthroplasty reduces variability in radiographic inclination: findings of a randomised controlled trial

2018 ◽  
Vol 28 (3) ◽  
pp. 240-245 ◽  
Author(s):  
Christopher K J O’Neill ◽  
Paul Magill ◽  
Janet C Hill ◽  
Christopher C Patterson ◽  
Dennis O Molloy ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Controlled Trial ◽  
Primary Outcome Measure ◽  
Patient Specific ◽  
Operating Table ◽  
Absolute Deviation ◽  
Total Hip ◽  
Lateral Decubitus ◽  
Randomised Controlled

Introduction: The study aims were to identify the incidence of pelvic adduction during total hip arthroplasty (THA) in lateral decubitus and to determine, when aiming for 35° of apparent operative inclination (AOI), which of 3 operating table positions most accurately obtained a target radiographic inclination (RI) of 42°: (1) horizontal; (2) 7° head-down; (3) patient-specific position based on correction of pelvic adduction. Methods: With patients seated on a levelled theatre table, a ruler incorporating a spirit level was used to draw transverse pelvic lines (TPLs) on the skin overlying the pelvis and sacrum. Subsequently, when positioned in lateral decubitus these lines provided a measure of pelvic adduction. 270 participants were recruited, with 90 randomised to each group for operating table position. In all cases target AOI was 35°, aiming to achieve a target RI of 42°. The primary outcome measure was absolute (unsigned) deviation from the target RI of 42°. Results: 266/270 patients demonstrated pelvic adduction (overall mean 4.4°, range 0– 9.2°). No patients demonstrated pelvic abduction. There were significant differences in RI between each of the 3 groups. The horizontal table group displayed the highest mean RI. The patient specific table position group achieved the smallest absolute deviation from target RI of 42°. Discussion: In lateral decubitus, unrecognised pelvic adduction is common and is an important contributor to unexpectedly high RI. The use of preoperative TPLs helps identify pelvic adduction and its subsequent correction reduces variability in RI. Clinical Trial Protocol number: NCT01831401.

Fascial Manipulation Associated With Standard Care Compared to Only Standard Postsurgical Care for Total Hip Arthroplasty: A Randomized Controlled Trial

PM&R ◽  
2016 ◽  
Vol 8 (12) ◽  
pp. 1142-1150 ◽  
Author(s):  
Massimo Busato ◽  
Cristian Quagliati ◽  
Lara Magri ◽  
Alessandra Filippi ◽  
Alberto Sanna ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Standard Care ◽  
Controlled Trial ◽  
Total Hip ◽  
Randomized Controlled

scholarly journals Comparing an eHealth Program (My Hip Journey) With Standard Care for Total Hip Arthroplasty: Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Rosemary Saunders ◽  
Karla Seaman ◽  
Laura Emery ◽  
Max Bulsara ◽  
Catherine Ashford ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Total Hip Arthroplasty ◽  
Outcome Measures ◽  
Hip Arthroplasty ◽  
Standard Care ◽  
Controlled Trial ◽  
Time Points ◽  
Total Hip ◽  
Randomized Controlled ◽  
Program Intervention

BACKGROUND The role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. OBJECTIVE The aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. METHODS A prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and at 3 and 6 months after surgery. The primary outcome was the Hip Dysfunction and Osteoarthritis Outcome Score. Secondary outcomes were a 5-level 5-dimension quality of life measure and the self-efficacy for managing chronic disease scale. Demographic and clinical characteristics were also collected. A satisfaction survey was completed by all participants 6 weeks after surgery, and those in the intervention arm completed an additional survey specific to the eHealth program. RESULTS A total of 99 patients were recruited: 50 in the eHealth program (intervention) and 49 in standard care (control). Clinical improvements were demonstrated in both groups across all time points. Per-protocol analysis demonstrated no differences between the groups for all outcome measures across all time points. Participants in the eHealth program reported that the program was accessible, that they felt comfortable using it, and that the information was helpful. CONCLUSIONS This study demonstrated that the eHealth program, in addition to standard care, had no additional benefit to THA recovery compared with standard care alone. The study found that the eHealth program was highly valued by participants, and it supported the preoperative preparation, recovery, and postoperative rehabilitation of participants. CLINICALTRIAL Australian New Zealand Clinical Trial Registry ACTRN12617001433392; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657

Preoperative pericapsular nerve group (PENG) block for total hip arthroplasty: a randomized, placebo-controlled trial

2021 ◽  
pp. rapm-2021-103228
Author(s):  
Jun Zheng ◽  
Danyang Pan ◽  
Bin Zheng ◽  
Xiangcai Ruan
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Local Anesthetic ◽  
Recovery Room ◽  
Controlled Trial ◽  
Final Analysis ◽  
Quadriceps Strength ◽  
Opioid Use ◽  
Total Hip ◽  
Pain Scores

BackgroundWe hypothesized that the addition of a preoperative pericapsular nerve group (PENG) block to intra-articular local anesthetic injection would improve analgesia after total hip arthroplasty.MethodIn this double-blinded trial, 71 patients scheduled for primary total hip arthroplasty were randomized to receive preoperative PENG block with 20 mL 0.5% ropivacaine (PENG group) or 20 mL saline (placebo group). All the patients received an intra-articular injection of 20 mL 0.5% ropivacaine by surgeon after the completion of the procedure. The primary outcome was the highest pain score reported in the recovery room. The secondary outcomes included quadriceps strength, pain scores, opioid use, and opioid-related side effects up to 48 hours after surgery.ResultsSeventy patients were included in the final analysis. The highest visual analog scale in the recovery room showed significant intergroup difference (placebo: 5.2±3.1 vs PENG: 3.3±2.7, p<0.01) but the difference did not persist after discharge from the recovery room. The two groups’ postoperative pain scores at rest were similar. A lower intraoperative morphine equivalent dose and lower postoperative vomiting were found in the PENG group. There were no differences in the other outcomes.ConclusionThe addition of a preoperative PENG block to intra-articular injections of local anesthetic provides a limited benefit to postoperative analgesia in the recovery room with no discernible benefits thereafter.Trial registration numberNCT04480320.

The learning curve following adoption of a novel short-stem prosthesis in total hip arthroplasty: implications on short-term patient outcomes

2018 ◽  
Vol 29 (4) ◽  
pp. 819-825 ◽  
Author(s):  
Jorge A. Padilla ◽  
Afshin A. Anoushiravani ◽  
James E. Feng ◽  
Ran Schwarzkopf ◽  
James Slover ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Learning Curve ◽  
Patient Outcomes ◽  
Hip Arthroplasty ◽  
Short Stem ◽  
Short Term ◽  
Total Hip

scholarly journals Augmented Rehabilitation Program for Young Patients Following Total Hip Arthroplasty

2021 ◽  
Author(s):  
Ahmed Negm ◽  
Milad Yavarai ◽  
Gian Jhangri ◽  
Robert Haennel ◽  
Allyson Jones
Keyword(s):  
Physical Activity ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Intervention Group ◽  
Young Patients ◽  
Rehabilitation Program ◽  
Control Group ◽  
Total Hip ◽  
The Impact

Abstract BackgroundThe increase rate seen in Total Hip Arthroplasty (THA) for younger patients has implications for future rehabilitation demands for primary and revision THA surgery. This study aims to determine the impact of a 6-week post-operative rehabilitation program designed for THA patients ≤ 60 years on physical activity (PA) and function compared to age- and a sex-matched control group received usual postoperative care at 12-week post-THA. MethodsIn this quasi-experimental study, a cohort of THA candidates was recruited during their 6-week postoperative visit to their surgeons. The out-patient rehabilitation program consisted of 12 structured exercise classes (2 hrs/class) over 6 weeks. Physical activity was assessed using Sense Wear Pro ArmbandTM [SWA]. Participants completed the Hip Osteoarthritis Outcome Score (HOOS), and THA satisfaction questionnaire before and immediately after the intervention. ResultsThe intervention group took significantly more steps/day at the follow-up compared to baseline. The intervention group had a higher mean change in the number of weekly PA bouts than the control group. Within the intervention groups, all HOOS subscales were significantly higher at the follow-up compared to baseline. ConclusionThe augmented rehabilitation program may have immediate effects on pain relief and symptom reduction for patients (≤60 years) following THA.

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