Early Recovery Outcomes in Patients Undergoing Total Hip Arthroplasty Through a Posterior Approach with Modified Postoperative Precautions

Abstract Introduction Recent data suggests that a modified, more lenient set of precautions after total hip arthroplasty (THA) performed through the posterolateral approach may safely allow more patient movement and exercise in the immediate postoperative period. We hypothesize that: 1) patients undergoing THA given modified precautions will demonstrate a fast-track return to functional activity and 2) wrist-based activity trackers will provide valuable information on post-operative activity levels. Methods We prospectively enrolled patients undergoing THA. Patients were given a wrist-based, commercially-available activity tracker to wear 1 week pre-operatively and 6 weeks post-operatively. Post-operative hip precautions included only the avoidance of the “leg-shaving” position of combined hip flexion, adduction and internal rotation. Linear mixed models were used to analyze change in steps and HOOS-JR data. Pearson correlation coefficients were used to describe the relationship between average steps and HOOS-JR scores over time. Results 82 patients were enrolled. 74% returned to work by week-4. 76% of left THA patients returned to driving by week-4. At 6 weeks, 23% of survey respondents were taking pain medication and 26% were using assistive devices. Average daily steps was 1,098 at week-1, 2,491 at week-2, 4,130 at week-3, 4,850 at week-4, 5,712 at week-5, and 6,069 at week-6. Significant correlation (R:-0.981) was found between increased weekly steps and improved HOOS-JR scores post-THA (P Conclusion Defining expected recovery timelines for patients undergoing THA helps surgeons counsel their patients pre-operatively. Our study demonstrates an expected pathway for recovery following THA by utilizing modified precautions that will be more clearly outlined with ongoing clinical data analysis.