8.22 THA Flashcards
What are the types of THA procedures?
- anterior
- posteroateral
- posterior
Where is the incision for anterior?
tiny incision in the inguinal space
- only cutting through skin and capsule
- everything else is retracted
Benefit to anterior approach
- Capsule is gone, but you still have all the musculature to protect
- Only precaution is no extreme extension
- Usually day surgery
What are the hip precautions for a posterior/posterolateral approach to THA?
- no adduction
- no IR
- no flexion past 90˚
Real life instructions for hip precautions?
DON’T:
- cross legs
- pick things up off the floor
- turn toward affected side
- lean forward in seated
DO:
- robot legs to walk
Why is it important to turn to the unaffected side?
Because they rotate around a fixated surgical site if they turn toward the injured side
Does the anterior approach preserve the capsule?
no
How long should hip precautions be followed generally?
3-6 months
Who will often get a dislocation after THA?
- pt that’s walking well, feeling good
- accidentally breaks hip precautions
What is the worst orthotic ever?
hip spica
hip dislocations
- affected leg will appear shorter
- easier to dislocate after the first one
What categories of therapy should be performed after THA?
- gait training
- Ther Ex
- education
- fall prevention if necessary
- stair training
- home eval questions
Ther Ex: things to do with a THA pt?
- glute sets
- heel slides
- ankle pumps
- 4 way hip
- SAQ, LAQ
- walk
What are ankle pumps important for?
blood flow - prevention of DT
SCD
sequential compression devices
lovenox
coumadin
blood thinners
What to look for when someone is on blood thinners?
- stomach issues
- intestinal ulcers
- diverticulutis
- sponaneous bleeding
Pt education (blood thinners)
- don’t eat leafy veggies
- vitamin K causes blood to thicken
How would you know if a pt’s blood is too thin?
- spontaneous bruising with no reason
- hematuria
- blood in stool
- s/s of PE
hematuria
peeing blood
blood in stool: bright red
- at colon or small intestine
- could be external or hemmorhoids
blood in stool: dark red/brown
- bleeding in stomach or intestines
- can come out in clots
TED hose
thromboembolytic deterrent
What should be done if a pt is wearing TED hose?
- check capillary refill
- ensure correct it
- look for wrinkles
Why is it better for someone with a THA to use a walker until after 2-4 weeks?
- people SEE a walker
- don’t always notice a cane
THA and OP therapy
- difficult to show a reason for them to get OP therapy
- most would benefit from balance, proprioception, gait, strength, etc.
What is the minimum velocity for safe community ambulation?
90-100 ft. per minute
Why is there a minimum velocity for safe community ambulation?
- crossing street
- getting out of a house on fire
- efficiency of gait (momentum vs. muscle actions)
