Evidence map›Paper›PMID 41361879›Full record

ArticleBMC musculoskeletal disorders2025

Implementation of hip replacement surgery recommendations: a qualitative study of orthopaedic surgeons' perspectives.

Rachael Powell, Amy Davies, Tony Coffey, Vikki Wylde, Helen Hickey, Hiren Divecha, Tim N Board

Abstract read
In one paragraph

Article in BMC musculoskeletal disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rachael PowellManchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK. rachael.powell@manchester.ac.uk.
Amy DaviesDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
Tony CoffeyLiverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK.
Vikki WyldeMusculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol, UK.
Helen HickeyLiverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK.
Hiren DivechaThe Centre for Hip Surgery, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK.
Tim N BoardThe Centre for Hip Surgery, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK.

Funding

National Institute for Health Research (NIHR) Research for Patient Benefit PB-PG-0817-20012
6 · The paper itself

Abstract

backgroundTotal hip replacement is a common surgical procedure in which the 'ball' and 'socket' components of the hip joint are replaced with implants. The HipHOP study (Hip arthroplasty with Hybrid Or cemented implants: Patient reported outcomes) evaluated the feasibility of conducting a randomised controlled trial of two implant types. Qualitative research was embedded within the HipHOP study and aimed to understand factors which might affect the implementation of a future trial's findings.

methodsSemi-structured qualitative interviews were conducted by telephone with sixteen orthopaedic surgeons. Purposive sampling ensured inclusion of surgeons who did and did not agree to their patients being included in the feasibility trial at two hospital sites, and also surgeons at a further two sites which were not involved in the feasibility trial. An inductive, thematic analysis was conducted, structured using the Framework approach. Findings were mapped to the Theoretical Domains Framework (TDF) and the Consolidated Framework for Implementation Research (CFIR).

resultsTo facilitate implementation of trial findings, it seemed important that advice be based on good quality research evidence showing clear benefits to the recommended approach and be supported by trusted professional organisations. Participants also considered the influence of surgeons' personal surgical results, recognising that outcomes may be affected by an individual surgeon's training and experience with an implant type. The importance of enabling surgeons to gain necessary skills was highlighted. The TDF seemed to be particularly valuable in understanding factors underlying implementation behaviour in this context, with the CFIR showing potential to contribute to understanding within some areas.

conclusionsFor a trial's findings to be influential in changing practice, it seems that: the trial needs to be well-designed and provide clear, strong findings; surgeons need to believe that changing practice will improve their personal outcomes; and suitable training opportunities need to be provided where surgeons lack experience using a recommended implant type. TRIAL REGISTRATION: Registered 19/02/2021, ISRCTN11097021.

Indexed as

Arthroplasty, Replacement, HipAttitude of Health PersonnelOrthopedic SurgeonsFeasibility StudiesFemaleHumansInterviews as TopicMaleQualitative ResearchCementedFeasibility studyHip replacementHybridImplant fixationImplementationQualitativeSurgeryTotal hip arthroplasty

Identifiers

PMID41361879
PMCPMC12797885

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.