case study 6 - Total Hip Replacement Flashcards
(26 cards)
what type of joint is the hip joint
ball and socket
what is the hip joint comprised of
- femoral head
- acetabulum (socket)
what muscles surround the hip joint
- rectus femoris
- psoas major
- iliacus
- gluteus minimus
- quadratus femoris
what is osteoarthritis
joint disease where tissues in the joint break down
- articular cartilage breaks down, overtime causing friction
describe the structure of a joint
- cartilage
- synovial membrane
- fibrous capsule
- joint capsule containing synovial fluid
what are clinical presentations of oseoarthritis?
- swelling around joint
- pain around joint
- stiffness
- inflammation
- restricted ROM
- ## crepitation sounds
what are the different hip surgeries/incisions
- anterolateral
- posteralateral
name for low blood pressure
hypotension
what is the normal degree of hip flexion
80-140
what is the normal degree of hip extension
5-40
what are the precautions of THR
- don’t go past 90 degree hip flexion due to risk of dislocation
- pain
- wound infection
- limited weight bearing
what is capillary refill time?
assesses peripheral perfusion quickly, must last less then 2 seconds
if capillary refill time is more then 2 what does this mean
could be caused by
- dehydration
- shock
- hypothermia
what is oxycodone
- opioid painkiller.
- slow release tablets
why is it important to know he is taking oxycodone
- ## side effects could affect the treatment
what are side effects of oxycodone
- arrythmias
- confusion
- dizziness
- headache
how would you asses decrease ROM in right hip
- test unaffected first actively to compare
- test affected hip active assisted
- compare both sides and state findings
how would you treat decreased rom in right hip
- get patient to perfrom:
- ankle pumps
- glute queezes
- quad squeezes
- patient to SOEOB and transfer to standing with WZF
- perform abduction, flexion, extension exercises
what evidence is there showing treatment for decreased rom in right hip
- NICE guidelines 2020 suggest early mobilisation for total hip replacements
- Kepp 2023 systematic review showed that early mobilisation reduced length of stay, increased walking mobility and reduced further joint complications
how would you assess decreased mobilisation doing transfers with WZF
- assess ROM of left compared to right hip
- assess strength whilst doing this
how would you treat decreased mobilisation doing transfers with WZF
- prior to mobilising, prescribe exercises such as:
- foot pumps
- glute squeezes
- quad squeezes
- get patient to stand and perform abduction, flexion, extension exercises
- progress to teaching how to transfer appropriately and walking with WZF
- get back to basleine
What evidence is there to treat decreased mobilisation doing transfers with WZF
- NICE guidelines 2020 suggest early mobilisation for total hip replacements
- Kepp 2023 systematic review showed that early mobilisation reduced length of stay, increased walking mobility and reduced further joint complications
how would you assess decreased strength right hip
- assess ROM + strength 3/5
how would you treat decreased strength right hip
start by prescribing
- ankle pumps
- glute squeezes
- quad squeezes
get patient to SOEOB and transfer to standing with WZF
perform abduction, flexion + extension exercises
progress to walking
