Background: Postoperative rehabilitation following total hip arthroplasty (THA) has evolved significantly, with early mobilization emerging as a critical component of enhanced recovery after surgery (ERAS) protocols. Despite growing adoption, variations in implementation and concerns about potential complications necessitate a rigorous evaluation of its efficacy.
Objective: This study systematically examines the impact of early mobilization (initiated within 24–48 hours postoperatively) on functional recovery, pain management, hospital length of stay (LOS), and postoperative complications compared to traditional delayed mobilization strategies.
Methods: A systematic review and meta-analysis were conducted following PRISMA guidelines. We searched PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) and prospective cohort studies published between January 2000 and December 2023. Studies were included if they compared early versus delayed mobilization in adults undergoing primary THA and reported at least one functional outcome measure. Two independent reviewers extracted data and assessed study quality using the Cochrane Risk of Bias Tool and Newcastle-Ottawa Scale. Random-effects meta-analysis was performed using RevMan 5.4.
Results: From 2,156 screened records, 27 studies (18 RCTs, 9 cohorts; n=4,217 patients) met inclusion criteria. Early mobilization significantly improved Harris Hip Scores at 6 weeks (MD=9.1, 95% CI 7.2–11.0, p<0.001) and 12 weeks (MD=7.8, 95% CI 5.6–10.0, p<0.001). Timed Up and Go test times were 3.9 seconds faster at 4 weeks (95% CI -5.2 to -2.6, p<0.001). Early mobilization reduced LOS by 2.1 days (95% CI -2.8 to -1.4, p<0.001) without increasing dislocation rates (RR=0.94, 95% CI 0.72–1.23, p=0.67) or venous thromboembolism (RR=0.89, 95% CI 0.65–1.21, p=0.46).
Conclusion: Early mobilization following THA produces clinically meaningful improvements in functional outcomes and reduces hospitalization duration without compromising safety. These findings support the integration of structured early mobilization protocols into standard postoperative care pathways.