Hip Surgical Flashcards
Legg-Calve-Perthe’s Disease
-AVN of proximal femoral epiphysis
-delayed ossification
-articular cartilage over-growth that lacks normal ossification
-bone distortion
-causes leg-length difference, decreased activity, possible total hip
-idiopathic
Hip Dysplasia
-general term for developmental pathology
-can lead to subluxation, dislocation, or loss of integrity of joint
What may I expect the pt to report and what will I observe when a degenerative process in the hip joint is present?
-c/o pain in groin, anterior thigh
-stiffness after rest
-limited motion–lose IR and then abd, ext, flex
-PROM has hard capsular end-feel
-impaired balance and postural control
Why would a person seek a hip replacement?
incapacitating pain
limited motion
impaired weight bearing
What should be assessed for preoperative THA?
strength, ROM, gait, balance, home environment, education
Complications of THA
intraoperative complications
early postop complications (DVT, infection)
late complication (loosening of device)
dislocation
leg length inequality
Postoperative management THA
report and discuss with surgeon
do not immobilize
weight bearing as tolerated
exercise and functional training
Maximum protection phase THA
at 6 weeks
no flexion >90°, no adduction or IR beyond neutral, monitor for dislocation (post approach), no extension (ant approach)
remember risk for DVT and immediate functional mobility
Exercises Max Protection
submaximal muscle setting
terminal knee ext while sitting
gravity eliminated hip abduction
weight shifting
to progress, you need FWB w/full knee extension
Moderate protection phase
4-8 weeks
-WB: full, regain endurance and strength
-know surgical work to abductors and extensors
Exercises Moderate Protection
standing, open chain
mini squats with weights
lateral step ups, hip hiking
bike or aquatic
hip flexor stretch over edge of sofa ( do not do for anterior approach)
progress when their is pain free ambulation, functional ROM
Minimum protection phase THA
-extended rehab and modification of activities if abductor weakness persists
-carry heavy objects on same side as THA
-return to sport
