Total hip replacement - College of Occupational Therapists

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Appendix 5: Evidence- based review tables Source Design and participants Intervention Outcomes Results Quality and comment Marks (2008) Retrospective cross- sectional Aim: examine if presurgical clinical presentation and short term functional outcomes differ between service users sub- groups undergoing hip joint replacement for end stage hip osteoarthritis Recruitment: records of 1000 consecutive THRs. From this cohort two groups identified – non- traumatic and those with past hip fracture history. n=42 in each group Male: female ratio = 17:25 Mean age: No trauma group 72.28 years Trauma group 74.05 years Total hip replacement. Pre- surgery: factors considered included body mass index, co- morbidity, duration of condition, pain, baseline hip flexion and internal rotation range of movement, presurgical walking status, leg strength Post- surgery: walking distance at 1 and 3 days. Those with traumatic fracture history reported: • More frequent use of mobility devices and dependency on wheelchair • Pre- surgical device use more prevalent (p=0.023) and poorer ambulatory function and stair climbing ability (p=0.001) • Lower rate of functional recovery postoperatively. Overall suggests those with prior hip fracture history have longer duration of disability and are more functionally impaired pre- surgery (p
Appendix 5: Evidence- based review tables Source Design and participants Intervention Outcomes Results Quality and comment Mobasheri et al (2006) Cross sectional design – retrospective Aim: to examine effect of THR on work status of service users under 60 years n=86 Service users post- operative between 6 months and 10 years Mean age 51.4 years Male: female ratio = 56:30 Questionnaire via telephone or in person United Kingdom. Total hip replacement. Questionnaire via telephone or at clinic postoperatively, items related to: • Profession • Employment status preand postoperatively • Length of time to resume work • Changes in working patterns • Reasons for not returning to work where relevant. Notes from preoperative used. Nearly all service users who were working preoperatively returned to their jobs 49/51 Of the 30 who were not employed preoperatively, 13 returned to the workforce. 17 remained unemployed Only 12/30 who were not working preoperatively were due to hip pain, therefore 18/30 had other reasons for not working. Of these 12, 11 returned to work postoperatively. Of the 19 not at work postoperatively – 5 were retired, 4 housewives and 10 reported they were not working for non- hip related reasons Return to work rates were average 10.5 weeks for those working preoperatively, and 35 weeks if not working preoperatively. Grade D – Very Low Downgraded from Grade C due to limitations: • Limited information on methodology • Length of time until follow-up (up to 10 years) possible bias in recall • Unclear if everyone responded • Single centre. Montin et al (2007) Cohort study – longitudinal follow- up Aim: to identify whether service users undergoing THR for osteoarthritis were anxious and whether anxiety was associated with service users healthrelated quality of life before and after surgery or with other background factors n=100 consecutively recruited Mean age 63.9 years Male: female ratio = 46%:54% Finland. Total hip replacement. Anxiety – measured by State- Trait Anxiety Inventory (STAI) Changes in healthrelated quality of life were evaluated by Sickness Impact Profile (SIP) Background, environmental and surgery factors. Mean trait anxiety (STAI score) before surgery = 42.8 (Standard deviation 4.9). Age and preoperative pain associated with trait anxiety, with a significant correlation (p
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Occupational therapy for adults und
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Occupational therapy for adults und
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Contents Foreword by Professor Avri
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Foreword I am delighted to have bee
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Key recommendations for implementat
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Key recommendations for implementat
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1 Introduction Total hip replacemen
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Introduction Health education of pu
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Introduction In terms of best pract
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Introduction other members of the m
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Introduction surgery, the role of t
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3 Guideline scope 3.1 Clinical ques
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Guideline scope • There are no re
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4 Guideline development process Det
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Guideline development process contr
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5 Guideline methodology 5.1 Guideli
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Guideline methodology 5.3 Criteria
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Guideline methodology Table 3: Grad
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Guideline methodology A recommendat
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6 Background to clinical condition
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7 Guideline recommendations The rec
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Guideline recommendations The inter
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Guideline recommendations mean leng
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Guideline recommendations assessmen
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Page 87 and 88: Appendix 5: Evidence- based review
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Page 113 and 114: Appendix 6: Glossary and abbreviati
Page 115 and 116: References Evidence references Bere
Page 117 and 118: References Lin JJ, Kaplan RJ (2004)
Page 119 and 120: References Wang W, Morrison TA, Gel
Page 121 and 122: References Health and Care Professi
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