Are National Guidelines for Total Hip Replacement in the UK Reflected in Practice?

Abstract

INTRODUCTIONA cross-sectional study was performed to compare the practice of total hip replacement (THR) in the UK against national guidelines.MATERIALS AND METHODSA postal questionnaire was sent to all fellows of the British Orthopaedic Association.RESULTSOf the 1587 questionnaires sent out, 966 (60.9%) were returned. Of these, 706 (73.1%) were available for data collection and analysis.CONCLUSIONSConsensus was observed in several areas including the use of pre-admission clinics and modern cementing techniques. Facilities deemed necessary for THR surgery such as HDU/ITU back-up, ultra-clean air and dedicated orthopaedic wards are almost universally available. However, a lack of consensus is evident in many areas including the process of obtaining written consent, thrombo-embolic prophylaxis, duration of antibiotic prophylaxis, supervision of trainee surgeons and follow-up arrangements. The proliferation in the range of implants, particularly aimed at ‘younger’ patients, available to surgeons has once again been highlighted.