title: Recovery of function following hip resurfacing arthroplasty: a randomized controlled trial comparing an accelerated versus standard physiotherapy rehabilitation programme.
abstract: OBJECTIVE
  To identify if a tailored rehabilitation programme is more effective than standard practice at improving function in patients undergoing metal-on-metal hip resurfacing arthroplasty.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Specialist orthopaedic hospital.
  
  
  METHODS
  80 men with a median age of 56 years.
  
  
  METHODS
  Tailored post-operative physiotherapy programme compared with standard physiotherapy.
  
  
  RESULTS
  Primary outcome - Oxford Hip Score (OHS), Secondary outcomes: Hip disability and Osteoarthritis Outcome Score (HOOS), EuroQol (EQ-5D-3L) and UCLA activity score. Hip range of motion, hip muscle strength and patient selected goals were also assessed.
  
  
  RESULTS
  At one year the mean (SD) Oxford Hip Score of the intervention group was higher, 45.1 (5.3), than the control group, 39.6 (8.8). This was supported by a linear regression model, which detected a 5.8 unit change in Oxford Hip Score (p < 0.001), effect size 0.76. There was a statistically significant increase in Hip disability and Osteoarthritis Outcome Score of 12.4% (p < 0.0005), effect size 0.76; UCLA activity score differed by 0.66 points (p < 0.019), effect size 0.43; EQ 5D showed an improvement of 0.85 (p < 0.0005), effect size 0.76. A total of 80% (32 of 40) of the intervention group fully met their self-selected goal compared with 55% (22 of 40) of the control group. Hip range of motion increased significantly; hip flexion by a mean difference 17.9 degrees (p < 0.0005), hip extension by 5.7 degrees (p < 0.004) and abduction by 4 degrees (p < 0.05). Muscle strength improved more in the intervention group but was not statistically significant.
  
  
  CONCLUSIONS
  A tailored physiotherapy programme improved self-reported functional outcomes and hip range of motion in patients undergoing hip resurfacing.
authors.affiliation: Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK. Karen.Barker@ouh.nhs.uk
authors.forename: Karen L
authors.initials: KL
authors.lastname: Barker
authors.forename: Meredith A
authors.initials: MA
authors.lastname: Newman
authors.forename: Tamsin
authors.initials: T
authors.lastname: Hughes
authors.forename: Cath
authors.initials: C
authors.lastname: Sackley
authors.forename: Hemant
authors.initials: H
authors.lastname: Pandit
authors.forename: Amit
authors.initials: A
authors.lastname: Kiran
authors.forename: David W
authors.initials: DW
authors.lastname: Murray
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000379:methods / Q000534:rehabilitation*; D004185:Disability Evaluation; D006040:Goals; D006622:Hip Prosthesis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D020127:Recovery of Function
keywords: Arthroplasty; physiotherapy; randomized controlled trial; range of motion