Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland : a qualitative study

Krygowski, Jaroslaw; Reicherzer, Leah; Marcin, Thimo

doi:10.57187/s.3536

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-29897

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland : a qualitative study
Authors:	Krygowski, Jaroslaw Reicherzer, Leah Marcin, Thimo
et. al:	No
DOI:	10.57187/s.3536 10.21256/zhaw-29897
Published in:	Swiss Medical Weekly
Volume(Issue):	154
Issue:	1
Page(s):	3536
Issue Date:	4-Jan-2024
Publisher / Ed. Institution:	EMH Swiss Medical Publishers
ISSN:	1424-3997
Language:	English
Subjects:	Total hip arthroplasty; Hip precaution; Qualitative expert interview
Subject (DDC):	615: Pharmacology and therapeutics 617.5: Orthopaedic surgery
Abstract:	Background: Growing evidence raises doubts about the need for routine hip precautions after primary total hip replacements to reduce the risk of postoperative dislocation. However, hip precautions are still routinely and widely prescribed in postoperative care in Switzerland. We aimed to investigate experts’ clinical reasoning for hip precaution recommendations after total hip arthroplasty. Methods: Using a convenience sampling strategy, 14 semi-structured expert interviews were conducted with surgeons, physiotherapists, and occupational therapists in the vicinity of an inpatient rehabilitation clinic in Switzerland. Data analysis followed Mayring’s principle of inductive and deductive structuring content analysis. Results: Expert statements from the interviews were summarised into four main categories and 10 subcategories. Categories included statements on the incidences of dislocation and underlying risk factors; current preferences and use of hip precautions; their effect on physical function, anxiety, or costs; and patient’s adherence to the movement restrictions. Hip surgeons routinely prescribed hip precautions, although in different variations. Fear of dislocation and caution are barriers to changing current practice. Some surgeons are considering individualised prescribing based on patients’ risk of dislocation, which therapists would welcome. Conclusion: A lack of clear instructions from the surgeon leads to ambiguity among therapists outside the acute hospital. A shared understanding of the need for and nature of hip precautions, guidelines from societies, or at least specific instructions from surgeons to therapists are warranted.
URI:	https://digitalcollection.zhaw.ch/handle/11475/29897
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Physiotherapy (IPT)
Appears in collections:	Publikationen Gesundheit

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Krygowski, J., Reicherzer, L., & Marcin, T. (2024). Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland : a qualitative study. Swiss Medical Weekly, 154(1), 3536. https://doi.org/10.57187/s.3536

Krygowski, J., Reicherzer, L. and Marcin, T. (2024) ‘Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland : a qualitative study’, Swiss Medical Weekly, 154(1), p. 3536. Available at: https://doi.org/10.57187/s.3536.

J. Krygowski, L. Reicherzer, and T. Marcin, “Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland : a qualitative study,” Swiss Medical Weekly, vol. 154, no. 1, p. 3536, Jan. 2024, doi: 10.57187/s.3536.

KRYGOWSKI, Jaroslaw, Leah REICHERZER und Thimo MARCIN, 2024. Clinical reasoning for the continuation or discontinuation of hip precautions after total hip arthroplasty in Switzerland : a qualitative study. Swiss Medical Weekly. 4 Januar 2024. Bd. 154, Nr. 1, S. 3536. DOI 10.57187/s.3536

Krygowski, Jaroslaw, Leah Reicherzer, and Thimo Marcin. 2024. “Clinical Reasoning for the Continuation or Discontinuation of Hip Precautions after Total Hip Arthroplasty in Switzerland : A Qualitative Study.” Swiss Medical Weekly 154 (1): 3536. https://doi.org/10.57187/s.3536.

Krygowski, Jaroslaw, et al. “Clinical Reasoning for the Continuation or Discontinuation of Hip Precautions after Total Hip Arthroplasty in Switzerland : A Qualitative Study.” Swiss Medical Weekly, vol. 154, no. 1, Jan. 2024, p. 3536, https://doi.org/10.57187/s.3536.