Are national guidelines for total hip replacement in the UK reflected in practice?

Abstract

Introduction: A cross-sectional study was performed to compare the practice of total hip replacement (THR) in the UK against national guidelines. Materials and methods: A postal questionnaire was sent to a ll fellows of the British Orthopaedic Association. Results: Of the 1587 questionnaires sent out, 966 (60.9%) were returned. Of these, 706 (73.1%) were available for data collection and analysis. Conclusions: Consensus 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.