NTvO JUN 2006 ED_2 - Nederlands Tijdschrift voor Orthopaedie

onderbouwen. Het aantal primaire THP’s dat per jaarwordt geïmplanteerd rechtvaardigt de uitvoering vaneen systematische ‘review’, zodat in de toekomst een zopraktisch, zinvol en eenduidig mogelijk nabehandelingtrajectvoor de patiënten voorhanden is.ABSTRACTThe large difference in length of hospital stay (mean 10.4 withregard to 5-7 in joint recovery projects) suggests variability inclinical treatment of patients who have undergone primary TotalHip Arthroplasty (THA) by posterolateral approach in Dutchhospitals.To obtain insight in this variability a survey was mailed to theOrthopaedic Surgery Departments of 110 Dutch hospitals. 70surveys were returned completed. The majority (55 out of 70)of the respondents, using a posterolateral approach in THA, usea post-operative protocol. Only about 20% of these protocols is“evidence based” .The information derived from this survey shows a large variabilityin physiotherapy following THA in terms of first day of postoperativemobilisation, choice of assistive device, permitted levelof weight bearing, instructed gait pattern and duration of usingcrutches.Considering the large number of primary THA operations performedannually, implanted by posterolateral approach, it is importantto create a post-operative clinical treatment that ispractical, meaningful and as unambiguous as possible. Conductinga systematic review is the most appropriate first step toachieve evidence based consensus between the Dutch hospitals.LITERATUUR1. Prismant, landelijke medische registratie 2004. Postbus85200, 3508 AE Utrecht, Nederland.2. Swedish National Hip Arthroplasty Register, JointReplacement Unit, Department of orthopaedics, Faculty ofmedicine, Göteborg University.3. Wagemakers A. Vergrijzing en de kosten van de gezondheidszorg.LBL, expertisecentrum leeftijd en maatschappij,Utrecht, 2003.4. Ostendorf M, Johnell O, Malchau H, Dhert W, SchrijversA, Verbout J. The epidemiology of total hip replacement inthe Netherlands and Sweden. Acta Orthop Scand 2002; 73(3): 282-86.5. Okhuijsen S, Dhert W, Faro L, Schrijvers A, Verbout A. Detotaleheupprothese in Nederland. Ned. Tijdschr Geneesk1998; 142 (25): 1434-37.6. Wirtz D C, Heller K D, Niethard F U. BiomechanischeAspekte der Belastungsfähigkeit nach totalendoprothetischemErsatz des Hüftgelenkes. Z Orthop Ihre Grenzgeb1998; 136: 310-16.7. Sonntag D, Uhlenbrock D, Bardeleben A, Käding M, HesseS. Gait with and without forearm crutches in patients withtotal hip arthroplasty. Int J Rehabil Res 2000; 23: 233-43.8. Rao R R, Sharkey P F, Hozack W J, Eng K, Rothman R H.Immediate weightbearing after uncemented total hip arthroplasty.Clin Orthop 1998; 349: 156-62.9. Bodén H, Adolphson P. No adverse effects of early weightbearing after uncemented total hip arthroplasty. ActaOrthop Scand 2004; 75 (1): 21-29.Vol.13juni’06NEDERLANDS TIJDSCHRIFT VOOR ORTHOPAEDIE ■ 113