Do lifestyle restrictions and precautions prevent dislocation after total hip arthroplasty?

This systematic literature review and meta-analysis was conducted on the effectiveness of lifestyle restrictions and precautions to prevent dislocation after total hip arthroplasty. A total of 119 eligible articles were identified, six were included: three randomized controlled trials, one retrospective matched cohort study, one retrospective and one prospective cohort study, describing 1122 procedures (restrictions group: n = 528; no restrictions group: n = 594). Both the standard posterior and anterolateral surgical approaches were included. There were eight dislocations (1.5%) in the restricted group, vs. six dislocations (1.0%) in the unrestricted group. Patients in the unrestricted group returned to activities significantly faster and were more satisfied with the pace of their recovery.

The review found that a more liberal lifestyle restrictions and precautions protocol will not lead to worse dislocation rates following total hip arthroplasty, but will result in earlier and better resumption of activities and higher patient satisfaction. These results seem to hold up for various surgical approaches.

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