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Results of Rehab for Primary and Revision Hip Replacement

More and more adults with arthritis are having total hip replacements (THR) at a younger age. Revision surgery is also on the rise because the implant has a limited life and wears out.

In this study, researchers at the University of Virginia Health System report on the results of rehab for both primary (first) and revision THR. They included 255 primary THR patients and 147 cases of revision THR.

Tests of function were given all patients at the time of admission. Patients were tested again after surgery. Activities measured included stair stepping, walking, dressing, wheelchair mobility, and transfers. After surgery, everyone was enrolled in therapy three hours a day for up to two weeks.

Results showed lower scores for patients with a revision THR. This was especially true for those who had a hip joint infection. Patients having a revision THR stayed in the hospital longer. Total rehab hospital charges were higher for the revision group, too.

Revision patients were less likely to go home from the hospital. Pain and other complications resulted in more revision patients going to skilled nursing facilities (SNFs) before going home. Patients who come to the hospital with lower levels of skill are also more likely to go to a SNF after primary or revision THR.

One final result reported in this study was the negative effect of abductor brace use after surgery. These braces are designed to keep the legs apart. The goal is to reduce the risk for hip dislocation.

However, it appears that using this brace limits the patient's movement. Patients who used abductor braces had higher hospital costs and were more likely to need further care before discharge to home. The authors suggest further study to look at the true need for the abductor brace following primary or revision THR.

References: Kevin R. Vincent, MD, et al. Outcomes After Inpatient Rehabilitation of Primary and Revision Total Hip Arthroplasty. In Archives of Physical Medicine and Rehabilitation. August 2006. Vol. 87. No. 8. Pp. 1026-1032.

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