[What is the interest of early mobilization after total hip arthroplasty? Development of French guidelines for clinical practice]. / Intérêt d'une mobilisation très précoce après la pose d'une prothèse totale de hanche ? Elaboration de recommandations françaises pour la pratique clinique.

AIMS: To develop clinical practice guidelines for early mobilisation after total hip replacement (THR). METHOD: We used the French Society of Physical and Rehabilitation Medicine (Sofmer) methodology, which associates a systematic review of the literature, the collection of information regarding current clinical practice and external review by a multidisciplinary expert panel. RESULTS: Recommending early mobilisation after THR is not established by a review of the literature. A survey of French clinical practice allows for recommending early mobilisation in the context of complex hip issues. Trials with good methodology must be developed to evaluate the interest of early functional mobilisation corresponding to when patients first stand and take their first steps after surgery. These trials should focus mainly on the final pain, functional status, and reduction of handicap.

[Secondary screening for osteoporosis in patients admitted for hip fracture to a rehabilitation center. Results of a survey]. / Dépistage de l'ostéoporose après fracture de hanche en milieu de rééducation. Résultats d'une enquête.

GOALS: To determine prevalence, risk factors and treatment of osteoporosis in patients with hip fracture observed in a rehabilitation ward. BACKGROUND: Hip fractures are associated with up to 20% excess mortality in the first year after fracture and cause functional disability in most survivors. Despite available risk indices and physician information, osteoporosis is still underdiagnosed and undertreated. METHOD: We obtained history, clinical and biological data, and bone density (BD) data in 41 patients admitted with hip fracture to a rehabilitation care centre. RESULTS: Only 3 patients had known osteoporosis. Although 50% had at least 1 clinical risk factor, all patients showed osteopenic BD scores and 68% had osteoporotic scores; only one was correctly treated. DISCUSSION: As with international studies, our study shows that osteoporosis is underdiagnosed. Risk assessment tools allow for routine screening and preventive measures incorporated into standard care practice. The prevention of osteoporotic fracture can be promoted in rehabilitation centres.