Hip Intervention

Question 1

Pre-surgical Phase THA

Answer 1

Meet Patient
Assess Functional Status
Discuss Goals of the Patient
Instruct PRE's for Post-op
Demonstration of Ambulation with device

Question 2

Historical Inquiry Post THA

Answer 2

WB status?
Cemented, non-cemented, hybrid?
Type of approach?
Trochanteric Osteotamy?
Intraoperative complications?

Question 3

THA Mobilization

Answer 3

Day 1 post-op
OOB to chair mostly
Reduces wisk of DVT and Pneumonia

Question 4

THA PRE’s

Answer 4

Submaximal Isometric for 3-5 seconds

Question 5

THA Ambulation and ROM

Answer 5

Day 2, PROM

Question 6

Posterior approach precautions

Answer 6

Flexion >90°
Adduction across midline
IR of hip

Question 7

Anterior Approach precautions

Answer 7

Extension
ER
Abduction for 6-8 weeks

Question 8

Anterior Approach

Answer 8

Interval b/w TFL and G Med with partial reflection of mm or takedown of GT
Repair of G Med follows or GT reattached

Question 9

Posterolateral Approach

Answer 9

G. Max splitting and takedown deep ER

Posterior capsule and tendons repaired

Question 10

Posterolateral Approach contraindications

Answer 10

Dementia, stroke, seizure disorder

Question 11

Post-op instructions

Answer 11

Assistive Device
Positional Avoidance
Deep breathing/diaphragmatic and coughing exercises
Ankle Pumps to decrease risk of DVT

Question 12

THR complications

Answer 12

DVT
Dislocation of hip
Leg length inequality
Infection
Loosening

Question 13

THR complications

Answer 13

DVT
Dislocation of hip
Leg length inequality
Infection
Loosening

Question 14

Outcomes of THA 1 year post-op

Answer 14

Significant decrease in postural stability

Question 15

Congenital Coxa vara/valga

Answer 15

Vara is shorter limb, Valga is longer
Address acute symptoms
Equalize leg lengths where appropriate
Address mm. imbalances
Avoid high impact sports

Question 16

Femoral Anteversion/Retroversion

Answer 16

Address Acute symptoms
Foot orthotics
Muscle performance

Question 17

Legg-Calve-Perthe

Answer 17

Reduce the deforming forces of WB and muscle tension
Pt. often immobilized in abduction and slight IR
Crutch ambulation
Compression load intolerance training

Question 18

Slipped Capital Femoral Epiphysis

Answer 18

Requires surgical stabilization
Post-op: ROM, strengthening, maximize function
Educate: weight control, minimal sport participation

Question 19

Congenital Hip dislocation

Answer 19

Surgical correction or splinting
Gait training
ROM exercises
Developmental Transitioning

Question 20

Fractures

Answer 20

WB restrictions
Gait training
Gentle progressive ROM
PRE's
Balance Training

Question 21

Bursitis

Answer 21

Address acute symptoms
Address etiology
Muscle balance training
Structural alignment

Question 22

Avascular necrosis

Answer 22

Usually requires surgury

Question 23

OA

Answer 23

Maintain function
Relieve symptoms
Prevent deformity
Education for hip joint protection principles
BW reduction