Do pre- and post- rehabilitation influence hospital length of stay and patient recovery following total hip replacement in the UK? A systematic scoping review and Delphi study

Abstract

Pre-operative rehabilitation is an effective means of reducing Length of Stay (LoS), but little evidence is available on its influence on Total Hip Replacement (THR) patients. Hence, a review of UK-based experimental studies to evaluate the effect of physical therapy on LoS was performed. Subsequently, a narrative synthesis was employed to develop a three-round Delphi study targeting UK clinicians. The review and Delphi results showed that patients had higher satisfaction with education clinics, but nurse-led assessment and physiotherapist education were not superior to standard pre-operative practices. The Delphi highlighted the challenges and benefits of (p)rehabilitation and provided suggestions for THR best practices. In conclusion, the study shows that there is a lack of evidence on the effectiveness of (p)rehabilitation on LoS; further research is recommended into education, (p)rehabilitation and patient self-efficacy interventions to enhance THR patients' pathways.