Productive Partnerships

Whitlam Orthopaedic Research Centre

Hospital Inpatient versus Home-based rehabilitation after hip arthroplasty (HIHO 2) Flagship Project

As Australia’s population ages, there is an increased demand for total hip arthroplasty (replacement). In 2014 32,000 primary total hip arthroplasty procedures were undertaken in Australia. Hip arthroplasty involves removing the damaged joint surfaces and replacing them with an artificial joint (a prosthesis).

Following surgery, patients require some form of supervised rehabilitation. Presently, this most commonly involves inpatient or community based rehabilitation. Rehabilitation aims to improve one’s mobility, quality of life, and build strength in the muscles surrounding the new joint.

Utilisation of inpatient rehabilitation after total hip arthroplasty is varied across Australia. Referral rates from hospitals range from 0-79%, with greater referral typically observed amongst private hospitals. The variation in referral between public and private hospitals is not likely due to differences in need, but rather, differences in access and choice.

Inpatient rehab can be a costly treatment. Considering the large volume of hip arthroplasties being undertaken, the more intensive, more closely supervised inpatient programs impose a considerable burden on the health care budget. Despite this, there is currently no evidence that suggests patients may recover better if they participate in these more intensive programs.

In partnership with Medibank, Whitlam Orthopaedic Research Centre will undertake a study that will provide information which will improve the delivery of rehabilitation programs currently being provided for patients recovering from hip arthroplasty. The study aims to determine if 10 days of inpatient rehab followed by a monitored home program yields superior recovery in mobility at 26 weeks post-surgery compared to a monitored home program. To do this, patients will participate in a randomised controlled trial.