Preoperative Video-Based Education in Total Hip Arthroplasty

Total hip arthroplasty (THA) is a common orthopedic procedure in which early postoperative mobilization plays a key role in preventing complications, reducing pain, and accelerating functional recovery. However, fear of movement (kinesiophobia), insufficient preoperative preparation, and uncertainty regarding mobility expectations may negatively affect patients' early rehabilitation performance. Providing structured, standardized education before surgery has been shown to improve postoperative participation and enhance patient confidence, yet the most effective format of such education remains unclear.

This randomized controlled trial was designed to evaluate the impact of a preoperative video-based mobilization education program on postoperative kinesiophobia, pain during the first mobilization, and early mobilization characteristics among patients undergoing primary THA. A total of 96 participants were randomly assigned to an intervention group or a control group using a simple randomization method. Both groups received routine preoperative verbal education, while the intervention group additionally viewed a structured mobilization training video developed by a multidisciplinary team of orthopedic surgeons, physiatrists, physiotherapists, and orthopedic nurses.

The educational video included demonstrations of bed exercises, safe ambulation techniques with assistive devices, chair transfer mechanics, toilet use, stair negotiation, and postoperative precautions. All postoperative outcomes were measured on the first postoperative day following each patient's initial mobilization session. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TSK); pain intensity was measured using the Numerical Pain Rating Scale (NPRS) immediately before and after the first mobilization; and mobilization characteristics (duration, number of steps, activity level, and level of assistance required) were recorded using a standardized observation form.

The aim of the study was to determine whether video-based preoperative education provides measurable benefits compared with routine verbal instruction alone. By focusing on both psychological (kinesiophobia) and physical (pain and mobilization performance) outcomes, this trial seeks to contribute new evidence to the field of musculoskeletal rehabilitation and to support more effective perioperative education strategies in THA care. No adverse events related to the intervention were reported.

Inclusion criteria

Age 18 years or older

Able to communicate verbally

Scheduled for primary total hip arthroplasty

No major neurological disease

No major psychiatric disease

Able to participate in postoperative mobilization

Provided written informed consent

Exclusion criteria

Scheduled for revision total hip arthroplasty

Comorbidities that prevent safe mobilization (e.g., severe cardiopulmonary limitations, severe balance disorders)

Severe cognitive impairment affecting comprehension or cooperation

Any condition preventing participation in the mobilization protocol

Declining to provide informed consent