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Physical activity does not improve after hip replacement (2016-11-28)

New research from the University of East Anglia (UEA) shows that, surprisingly, patients’ physical activity does not increase following hip replacement surgery.

Total hip replacement is one of the most common elective operations, with more than 620,000 procedures performed in the UK from 2003-2013. The most prevalent cause for needing surgery is osteoarthritis (93 per cent).

But the research, published in the journal Clinical Rehabilitation, brings the purpose of a hip replacement into question.

Lead researcher Tom Withers, from UEA’s School of Health Sciences, said: “The most common reason for a hip replacement is to reduce pain on movement. We expected that the amount of physical activity post-surgery would therefore increase. What we found surprised us.”

This study is the first systematic review specifically to examine the differences in physical activity pre compared to post-surgery hip replacement.

A search was performed on 13 July 2016. Studies were eligible for inclusion if they presented preoperative and up to one year postoperative measures of physical activity for patients who had undergone unilateral primary total hip replacement.

Data was synthesised using a meta-analysis with 95% confidence intervals (CI), if appropriate. The Critical Appraisal Skills Programme cohort study checklist was used to assess the quality of evidence.

From 6024 citations, 17 studies were selected: Nine studies were analysed in a meta-analysis and eight studies were analysed qualitatively. The quality of the evidence was ‘low’ to ‘moderate’.

Lead researcher Tom Withers, from UEA’s School of Health Sciences, said: “The most common reason for a hip replacement is to reduce pain on movement. We expected that the amount of physical activity post-surgery would therefore increase. What we found surprised us.”

“Our study looked at data from about 1,030 patients who had received hip replacements. Indicators for physical activity after surgery included whether patients were walking longer distances, walking more quickly, cycling and climbing stairs.

“We found that there was no clear evidence of a change in physical activity following surgery.

“The benefits of regular physical activity following a hip replacement are well known, so this research is important for healthcare professionals because it suggests that patients need to be encouraged to be more physically active.”

The research used existing research papers measuring pre- and post-operative measures of physical activity.

Toby Smith, lecturer in physiotherapy in UEA’s School of Health Sciences, said: “The lack of significant difference in physical activity after patients undergo such a common procedure suggests there is a need for further research, including further investigation into how other personal characteristics or pre-existing conditions might also influence the results.

“Healthcare professionals and researchers need to better understand this lack of change and how patient’s perceptions of physical activity might be modified to increase their engagement in physical activity post-operatively.”

For more information
Clinical Rehabilitation
Is there a difference in physical activity levels in patients before and up to one year after unilateral total hip replacement?
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University of East Anglia (UEA)
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MDN