This study aims to design an accelerated rehabilitation plan tailored for the patients receiving DAA THA and also to assess its effects on postoperative recovery.
This study employs a randomized controlled trial design, targeting participants aged 40 to 75 who are scheduled for a DAA THA. After a thorough screening process, willing participants were randomly assigned to one of two groups: the usual care (UC) group or the accelerated rehabilitation (AR) group. The UC group received the current standard medical care in our hospital, while the AR group engaged to a quicker progressing protocol. They would have a preoperative consultation with a physical therapist to set rehabilitation goals, and received intensive postoperative interventions during hospital stay and also remote rehabilitation support until one month after surgery. Participants were evaluated multiple times: before surgery and at two, four, eight, and twelve weeks postoperatively. The statistical analyses included using two-way ANOVA to examine the trends in two groups for the different assessing times, and the independent t-test to compare outcomes between the two groups.
A total of 30 participants completed the study without any complications, with 15 in each group. Results showed significant improvements in hip flexor strength for both groups post-surgery, but differences between sides in the UC group persisted longer. Functional assessments using the Harris Hip Score (post-op 2 wk: p=0.017, 4 wk: p=0.010), Hip Dysfunction and Osteoarthritis Outcome Score (post-op 2 wk: p=0.013, 4 wk: p=0.007, 8 wk: p=0.034) and Western Ontario and McMaster Universities Arthritis Index (post-op 2 wk: p=0.012, 4 wk: p=0.004) demonstrated that the AR group scored significantly higher than the UC group from two weeks onward, continuing through four weeks and even at eight weeks. Balance tests indicated that the AR group exhibited greater stability than the UC group at certain time points (post-op 2 wk: p=0.024, 4 wk: p=0.043), while gait analysis revealed significant enhancements in stride length (post-op 2 wk: p=0.005) and walking velocity (post-op 2 wk: p=0.009) for the AR group.
The findings of this study suggest that implementing an accelerated rehabilitation plan can significantly enhance early strength recovery and functional performance in patients undergoing direct anterior THA.
This approach appears to be more effective than traditional care methods. Future research should consider applying this rehabilitation model in various clinical settings and for other patient populations, highlighting its potential for broader application and development.
total hip arthroplasty
accelerated rehabilitation
