Post Op Hip Management Flashcards
(17 cards)
Arthroplasty general principles of rehabilitation
- individualization
- promote optimal motion and proper activation of muscle
- add breathing to exercise
- soft tissue and scar mobilization
- understand patient expectation and fear avoidance behavior
- look beyond injured/surgical site
- consider MS diagnosis
- use standards measure
Step of rehab arthroplasty
- phase 1 : MWB
- phase 2 : partial WB to full WB
- phase 3 : full WB
- phase 4 : return to sport
Precaution arthroplasty
- no driving until full WB
- medication: pain, constipation, anticoagulant
Phase 1: MWB description (arthroplasty)
- gait with assistive devices
- sitting with hip higher than knee, feet supported, no crossing legs
- strategies in STS
- sleeping with cushion
- exercise : ROM (F up to 90; E at 0; hip IR-ER (labral tear consideration); hip AB- AD)
Strengthening of gluteus maximus without going over 0.
Start High bike and aquatherapy therapy ASAP - decrease pain and swelling
- ankle pump
- monitor patient pain medication
- strengthening while maintaining hip precaution
Phase 2 : Partial WB to Full WB (arthroscopy)
- correct standing alignment
- progress to full WB
- strategies STS
- progress ROM and active exercise
- high bike and aquatherapy
- abdominal strengthening
- initiation of balance and neuromuscular exercise
- gentle stretching of LE muscle
Phase 3: full WB
- increase distance of walking and try varying surfaces
- strengthening and endurance LE muscle
- keep ROM training, precision of motion and muscle perf
- progress neuromuscular and balance training
- start sport specific exercise
- provide feedback for fear avoidance and reduce fear
Phase 4: RTS
- maximize strength and endurance of LE
- maximize power, agility and speed
- progress sport specific
- education on maintenance hip program
- provide feedback for motivation and reduce fear
Osteotomy early complication
- wound healing
- hypersensitivity
- paraesthesia
- DVT
- bladder control
Osteotomy mate complication
- hardware
- scar tissue
- plan for surgery other hip
- leg length difference
- iliopsoas snapping
- other painful region
Labral tear devices
- brace
- rotational boots to limit LR
What is Periacetabular osteotomy for?
Treating symptomatic hip dysplasia
Types of Periacetabular osteotomy
- Rectus femoris is detached
- Rectus femoris is spared
Rectus femoris detached as the same rehabilitation than spares femoris but it’s longer because as no active hip flexion for 6 weeks
How much phase as Periacetabular osteotomy rehabilitation?
4
Phase 1 : Periacetabular osteotomy
Same phase 1 arthroscopy but can go up to 50% WB
Phase 2: PAO
-Partial WB to full
- active motion to gentle strengthening ( no resistance until 6 weeks)
- soft tissue mobilization
Phase 3: PAO
- full WB
- sport readiness
- add resistance to strengthening
Phase 4: PAO
Return to sport
