Phased rehabilitation nursing improves hip function, reduces complications, and enhances quality of life following total hip arthroplasty: A prospective quasi-experimental cohort study

Total hip arthroplasty (THA) is the definitive treatment for advanced hip disease; however, postoperative rehabilitation remains challenging, particularly in elderly patients with multiple comorbidities. This study evaluated the effectiveness of phased rehabilitation (PR) nursing versus routine care on recovery outcomes following THA. This prospective quasi-experimental cohort study included 100 patients who underwent primary unilateral THA at Ankang People’s Hospital from January 2023 to December 2024 and were assigned to either a study group (n = 50) receiving a 3-phase rehabilitation nursing protocol or a control group (n = 50) receiving routine postoperative care. Group allocation was determined by ward assignment and nursing team availability rather than formal randomization. The phased protocol included structured progression from early muscle stimulation and mobilization (phase 1) to functional transition training (phase 2) and advanced mobility training (phase 3). Primary outcomes were pain intensity (Visual Analog Scale) and hip function (Harris Hip Score). Secondary outcomes included quality of life (Short-Form 36), complications, and patient satisfaction, assessed at 3 and 6 months postoperatively. Repeated-measures analysis of variance was employed to evaluate longitudinal changes, supplemented by pairwise comparisons at each time point. At 6 months, the PR group demonstrated significantly lower pain scores (Visual Analog Scale) and superior hip function (Harris Hip Score) compared with the control group ( P < .05). Repeated-measures analysis of variance confirmed significant time-by-group interaction effects for primary outcomes (all P < .05). The intervention group also had a significantly lower overall complication rate (2.0% vs 16.0%, P = .01), although the small absolute number of events warrants cautious interpretation. Furthermore, patients who received PR reported significantly better outcomes across all 8 domains of the Short-Form 36 quality of life survey, greater functional independence (Barthel Index), higher self-care capacity (Exercise of Self-care Agency Scale), better exercise compliance (96% vs 80%), and higher patient satisfaction (94% vs 78%; all P < .05). PR nursing significantly enhances recovery after THA through systematic, progressive interventions tailored to recovery stages, thereby reducing complications and improving functional outcomes, quality of life, and patient satisfaction. These findings, derived from a single-center quasi-experimental design, require confirmation through multicenter randomized controlled trials.