“Hip Precautions”

TheKettleBellPhysioUncategorized0 Comments

In another fantastic chat on The Physio Matters Podcast (@TPMPodcast), in Session 35 Jack Chew (@Chews_Health) talks with Toby Smith (@TobyOSmith) about hip osteoarthritis and total joint replacements.

Dislocation is a horrible complication following a hip replacement. OTs and PTs have historically and been so fearful of causing a dislocation that they have for a very long time given out and followed ‘hip precautions’ in an effort to reduce the likelihood of it occurring. BUT, guess what happens when they’re not given and patients are simply encouraged to be as active as they want… absolutely nothing.

As a student Physio myself in 2011/12 we had local Orthopaedic Surgeon Dr David Liu present to us exactly the same outcomes with his own patients having taken away precautions. This is not knew data.

The evidence simply doesn’t support hip precautions have any effect on incidence of dislocation.

The single biggest factor is not the individual’s behaviour post-operatively e.g. crossing of legs, it is the surgical procedure itself (not being sufficient stable).

On the whole, they generally are very stable – you see: https://twitter.com/traumatologoalD/status/796489252586586112

Despite this, Toby reveal that in a national survey of PTs and OTs in the UK, 4% of the responders were not only still recommending the unsupported precautions, but advising patients that they needed to follow them for LIFE!

If you listen to the podcast, you’ll hear Jack’s surprise and utter disbelief at this level of professional incompetence.

I *want* my clients to ask me to justify what I doing to help them. I want them to ask me why I’m doing what I’m doing. I want them to ask me for the evidence to support my practice.

If you’re receiving help from a Physiotherapist, I passionately believe that you be able to ask those questions and feel comfortable and justified in doing so. The Physiotherapy profession should be held accountable to higher standards of evidence-informed practice.

What bothers me the most, is that 4% is just the tip of an ice berg.

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