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Scott Cheatham, Monique Mokha and Matt Lee


Hip-resurfacing arthroplasty (HRA) has become a popular procedure in the treatment of hip-joint arthritis in individuals under the age of 65 y. Although the body of literature examining operative procedures has grown, there is a lack of consistent reporting of the effectiveness of an HRA postoperative rehabilitation program. To date, no systematic reviews have evaluated the available evidence on postoperative rehabilitation programs.


To evaluate the available evidence on postoperative rehabilitation programs after HRA.

Evidence Acquisition:

A systematic review was conducted according to the PRISMA guidelines. A search of PubMed, CINAHL, SPORTDiscus, ProQuest, and Google Scholar was conducted in April 2014 using the following keywords alone and in combination: postoperative, postsurgical, rehabilitation, physical therapy, programs, hip resurfacing, arthroplasty, and metal-on-metal. The grading of studies was conducted using the PEDro and Oxford Centre for Evidence-Based Medicine scales.

Evidence Synthesis:

The authors identified 648 citations, 4 of which met the inclusion criteria. The qualifying studies yielded 1 randomized control trial, 2 case reports, and 1 case series, for a total of 90 patients. Patients were mostly male (n = 86), had a mean age of 48 ± 5.47 y, and had been physically active before HRA. Postoperative rehabilitation programs varied in length (range 8–24 wk) and consisted of at least 3 phases. The methodology to assess program effects varied, but all 4 studies did measure a combination of function, pain, and quality of life using written questionnaires, with follow-up ranging from 9 mo to 1 y. The most common questionnaire was the Harris Hip Score.


This review found postoperative rehabilitation programs after HRA to be underinvestigated. Limited results indicate that postoperative rehabilitation programs may be effective in improving gait (stride length, velocity, and cadence), hip range of motion, and pain and function, as measured by questionnaires, but not hip strength.

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Alyssa C. Adams, Kelly B. Fleming and Patricia M. Tripp

of increase in prevalence of this condition. The success rate of Bernese hip PAO is high, with good, reproducible long-term results that help prevent the need for a hip replacement later in life. 3 , 4 The lack of research on return to competitive play after hip PAO, however, presents a challenge to

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James A. Ashton-Miller and Ronald F. Zernicke

can trust to provide critical feedback. Ron : When I think of a successful “reversal” of failure, I immediately am reminded of the Hip and Knee Replacement Project that was developed in the Province of Alberta, Canada. 3 Prior to the development of a new, integrated continuum of care for total hip

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Keith Baar

). Long-term implant fixation and stress-shielding in total hip replacement . Journal of Biomechanics, 48 ( 5 ), 797 – 800 . PubMed ID: 25579990 doi:10.1016/j.jbiomech.2014.12.021 10.1016/j.jbiomech.2014.12.021 van Ark , M. , Cook , J.L. , Docking , S.I. , Zwerver , J. , Gaida , J.E. , van

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Daniël M. van Leeuwen, Fabian van de Bunt, Cornelis J. de Ruiter, Natasja M. van Schoor, Dorly J.H. Deeg and Kaj S. Emanuel

present. Exclusion criteria were hip OA, total knee or hip replacement, uncontrollable high blood pressure, or contraindications for electrical stimulation (unstable epilepsy, cancer, skin abnormalities, or a pacemaker). All participants included in this study had a Western Ontario and McMaster

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Chen Deng, Jason C. Gillette and Timothy R. Derrick

 = 2–4), and the subjects were atypical since they had undergone hip replacement surgery within 11 to 31 months prior to testing. Although this procedure provides a direct measure of the hip joint forces, the invasive nature and limited subject pool reduce the practicality of this protocol in most

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Nathaniel S. Nye, Drew S. Kafer, Cara Olsen, David H. Carnahan and Paul F. Crawford

Nutr . 2009 ; 12 ( 3 ): 359 – 368 . PubMed 18426630 14. Wang Y , Simpson JA , Wluka AE , et al . Relationship between body adiposity measures and risk of primary knee and hip replacement for osteoarthritis: a prospective cohort study . Arthritis Res Ther . 2009 ; 11 ( 2 ): R31 . PubMed doi

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Erik Sesbreno, Gary Slater, Margo Mountjoy and Stuart D.R. Galloway

hydration status confirmed all athletes presented in a euhydrated state. Second, three athletes with titanium bone plates, or rods and screws inserted in the upper or lower limb, were included in the study analysis. Titanium bone inserts, such as hip replacement devices have shown to increase the risk of

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Damien Moore, Adam I. Semciw, Jodie McClelland, Henry Wajswelner and Tania Pizzari

and following a total hip replacement. 10 , 11 Importantly, targeted atrophy of anterior GMin has been associated with a greater risk of falls. 21 With clinical presentation of segmental GMin dysfunction addressed previously, 22 rehabilitation of GMin must consider targeting both structurally and

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Jianwei Duan, Kuan Wang, Tongbo Chang, Lejun Wang, Shengnian Zhang and Wenxin Niu

running and walking on osteoarthritis and hip replacement risk . Medicine & Science in Sports & Exercise, 45 ( 7 ), 1292 – 1297 . PubMed ID: 23377837 doi: 10.1249/MSS.0b013e3182885f26 Wu , G. ( 2008 ). Age-related differences in Tai Chi gait kinematics and leg muscle electromyography: A pilot