A Cochrane review included 5 studies with a total of 619 subjects. All trials were of low quality with differences in study design and outcomes used. For inpatient settings (n=261, 2 trials) early commencement of rehabilitation and clinical pathways led to more rapid attainment of functional milestones (Functional Independence Measure (FIM) transfer WMD 0.5, 95% CI 0.15 to 0.85, number needed to treat to benefit [NNTB] = 6, FIM ambulation WMD 1.55, 95%CI 0.96 to 2.14, NNTB = 3), shorter hospital stay, fewer post-operative complications and reduced costs in the first three to four months. Home-based multidisciplinary care (n=358, 3 trials) improved functional gain (Oxford Hip Score [OHS] WMD at 6 months –7.00, 95%CI –10.36 to –3.64, NNT = 2) and quality of life and reduced hospital stay in the medium term (six months). No trials addressed longer-term outcomes following hip replacement only.
Comment: The quality of evidence is downgraded by limitations in study quality (lack of blinding) and by inconsistency (heterogeneity in interventions and outcomes).