What do clinicians think about hip precautions following total hip replacement?

Introduction: Hip precautions are routinely recommended by occupational therapists to reduce the risk of dislocation following total hip replacement. The purpose of this study was to report the views and experiences of clinicians on the use of hip precautions with this client group. Method: Data were gathered from six National Health Service trusts, through 16 semi-structured telephone interviews. Participants included occupational therapists, physiotherapists, surgeons and nurses and data were analysed thematically. Results: Themes identified were: the rationale for, and disadvantages of, routine hip precautions and issues in the consistency of their application; the barriers and facilitators to relaxing hip precautions and the process and impact of changing practice; the contextual factors of service change and support for further research. Conclusion: There is variation in the views of clinicians regarding hip precautions due to differences in surgical opinion and lack of evidence as to whether precautions affect the risk of dislocation. Relaxing the routine provision of hip precautions is perceived to have an impact on patient recovery and satisfaction, the role and skill mix of therapy services, length of hospital stay and resource use. Trials are urgently required to investigate the effect of hip precautions on patient and surgical outcomes.