PRE-OPERATIVE PHYSIOTHERAPY IN PRIMARY TOTAL HIP ARTHROPLASTY: CLINICAL, FUNCTIONAL AND QOL ANALYSIS EVALUATION

Abstract

Objective: To examine the effectiveness of a specific physiotherapy program before hip arthroplasty in patients with hip osteoarthritis.

Design: Multidimentional prospective randomised controlled study

Subjects: 25 patients meet the inclusion criteria and were randomised in a study and a control group

Intervention: All the patient underwent THA performed by the same surgeon and implanted with the same prosthesis. Study group performed educational and physiotherapy program one month before surgery. Study and control group performed inpatient rehabilitation program only post surgery.

Main outcome measures: patients were evaluated, 1 month before surgery(T0), the day before surgery (T1), 15 days (T2), at 4 weeks (T3) and at 3 months (T4) post surgery using measure of hip muscle strength, hip range of motion, Barthel Index, Short Form-36, WOMAC, Harris Hip Score (HHS), Visual Analogue Scale (VAS).

Results: The study group present significant improvement of hip extrarotation at each evaluation, significant high values of gluteus medius strength (p level 0,004) at T1, significant hip abduction (p level 0,02) at T3, significant lower score in VAS at T1 (p level −2,10), T3 (p level −2,10) and at T4 (p level 0,02), significant improvement in Womac scores (p level −2,32) at T4. In study group, SF 36 Physical composite score was significant high at T1(p level 0,048), Mental composite score at T2 (p level 0,006) and T3 (p level 0,02).

Conclusion: our pre surgery programme improves values of clinical status and social function, besides pain reduced before surgery until three months after surgery.