title: Minimal invasive posterior total hip arthroplasty: are 6 weeks of hip precautions really necessary?
abstract: BACKGROUND
  Postoperative hip dislocations have been reported in 0.5 to 10.6 % of patients after primary posterolateral total hip arthroplasty (THA). Hip precautions are currently recommended for 6 weeks postoperatively to reduce early dislocation and facilitate healing of the posterior soft tissue repair.
  
  
  METHODS
  To determine the impact of a modified 4-week precaution protocol on the dislocation rate, 698 consecutive patients (797 hips) operated by a single surgeon between September 2008 and December 2012 were retrospectively evaluated. All patients had a standard THA using a minimal invasive posterior approach with posterior soft tissue repair and 28-36-mm head size. 98.7 % of the patients were available for follow-up.
  
  
  RESULTS
  There were eight (1 %) dislocations in 797 hips in the first 12 months after surgery with 4 weeks of hip precautions. The average time to dislocation was 7.5 weeks after surgery (range 1.0-16.9 weeks); two dislocations (25 %) took place in the first 4 weeks.
  
  
  CONCLUSIONS
  Shortening the time of posterolateral hip precautions from 6 to 4 weeks after surgery does not increase the risk of postoperative dislocation.
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Schmidt-Braekling
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Wenzel
authors.initials: W
authors.lastname: Waldstein
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Erol
authors.initials: E
authors.lastname: Akalin
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Pablo
authors.initials: P
authors.lastname: Benavente
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Frykberg
authors.affiliation: Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA. boettnerf@hss.edu.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Boettner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods / Q000534:rehabilitation*; D005260:Female; D006617:Hip Dislocation / Q000209:etiology / Q000517:prevention & control*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011182:Postoperative Care; D012189:Retrospective Studies; D055815:Young Adult