PURPOSE: Day-zero ambulation may enable patients to recover and leave hospital quicker following total hip replacement (THR). The present randomised control feasibility study investigated the efficacy of day-zero ambulation as a physiotherapeutic intervention. METHODS: Thirty-six non-blinded adults aged 44 to 85 (mean 67.1; SD 9.6 years) undergoing primary, uncomplicated THR were block randomized to either a control group (n = 18) with standard post-operative physiotherapy or an intervention group (n = 18) incorporating walking on the same day as the operation. Outcomes were length of hospital stay (LOS), time to reach functional milestones and achieve all physiotherapy discharge criteria, post-operative pain scores, complications and patient experience. RESULTS: Participants treated with day-zero ambulation had reduced median hospital LOS of 1 day (p = 0.096), and median reduced times to reaching functional milestones of 39.7 h quicker to transfer to a chair (p < 0.001), 24.5 h quicker to walk 10 m (p = 0.009) and 26.4 h quicker to independently ascend and descend stairs (p = 0.01). Participants in the intervention group were deemed physiotherapy ready to leave hospital significantly earlier than control group (1.04 days, p = 0.015). CONCLUSIONS: Day-zero ambulation appears safe and may have clinically relevant effects in speeding patient functional recovery and facilitating earlier discharge from hospital.

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