Rehabilitation policies following total hip arthroplasty: Across borders

Total hip arthroplasty (THA) is considered one of the most successful, clinically effective, and cost-effective surgical treatments available. So far, consensus on rehabilitation following THA is lacking for type and timing of physiotherapeutic exercise, so there is heterogeneity in postoperative rehabilitation policies. This can be illustrated with two neighboring countries, the Netherlands and Germany, as the Dutch and German healthcare systems have a divergent vision and policy with respect to THA and postoperative rehabilitation.
The overall aim of this thesis was to study the effectiveness of postoperative rehabilitation by comparing different policies and a novel technological alternative. To this end, the first aim was to compare the clinical and cost effectiveness of the Dutch versus the German rehabilitation post-THA approach. The second aim was to investigate the feasibility and effectiveness of an e-health home-based rehabilitation program, which could be an alternative to formal physiotherapy.
It can be concluded that (1) a more intense postoperative rehabilitation following primary THA as handled in Germany is clinically advantageous. From a cost-effectiveness perspective, comparisons are less straightforward as the socio-economic context differs between both countries, although the German policy seems to benefit the working population; and (2) an e-health home-based rehabilitation program seems feasible and effective for patients following THA and could be a possible addition or alternative to formal physiotherapy in the Netherlands.