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April 30, 2026The Journal of Arthroplasty0 citationsOpen Access

Do Hip Precautions Matter After Posterior Approach Total Hip Arthroplasty With Capsular Repair? A Randomized Control Trial

AYAditya S. YadavAPAjay PotluriSDSiddhartha Dandamudi

Key Points

  • This study aims to examine the effect of hip precautions on dislocation rates following total hip arthroplasty.
  • Conducted a prospective, randomized study with 1,133 patients undergoing posterior approach primary THA
  • Participants were divided into a restricted motion group and an unrestricted motion group
  • Follow-up ranged from 0.1 to 8.6 years with a minimum of six weeks for analysis.
  • Ten dislocations (0.88%) noted, with six in the restricted group and four in the unrestricted group (OR: 0.60; 95% CI: 0.17 to 2.17; P = 0.547)
  • Higher Hip Disability and Osteoarthritis Outcome Scores in unrestricted group at six weeks and three to six months (P = 0.028 and P = 0.015 respectively)
  • No significant differences in 90-day complications or surgical revisions (all P > 0.209)

Abstract

Background:The clinical efficacy of posterior hip precautions in preventing dislocation after primary posterior approach total hip arthroplasty (THA) remains uncertain.Such mobility restrictions may delay patients' return to daily activities and functional recovery.The aim of this study was to determine whether THA hip precautions impact hip dislocation rates. Methods:We conducted a prospective, randomized study evaluating the effect of hip precautions on the risk of dislocation after primary THA.A total of 1,133 patients were enrolled and underwent posterior approach primary THA by multiple fellowship-trained surgeons at a single academic center between January 2016 and June 2025.Patients were randomized to either a restricted group, instructed to avoid hip flexion beyond 90, adduction past midline, and internal rotation for six weeks postoperatively, or an unrestricted group without restraint to motion or activity.Demographics, surgical indications, and prosthesis data were recorded.The minimum follow-up for analysis was six weeks.The primary outcome was dislocation; secondary outcomes included perioperative complications and patient-reported outcomes.The unrestricted and restricted groups included 567 and 566 patients, respectively, with no significant demographic or surgical differences (all P > 0.245).Follow-up was similar between groups (mean, 1.3 1.4 years; range, 0.1 to 8.6 years; P = 0.645).Statistical analyses used Fisher's exact test and t-tests using P 0.209). Conclusion:J o u r n a l P r e -p r o o fWe could not detect any difference in dislocation risk following routine use of strict hip precautions following posterior approach THA with capsular repair.These precautions may unnecessarily limit early functional recovery, increase patient anxiety, and negatively impact patient-reported outcomes.

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Cite This Study

Yadav et al. (2026) studied this question.

synapsesocial.com/papers/69f2f0e31e5f7920c6386ee6https://doi.org/10.1016/j.arth.2026.04.080
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