Hip Intervention Flashcards
Pre-surgical Phase THA
Meet Patient Assess Functional Status Discuss Goals of the Patient Instruct PRE's for Post-op Demonstration of Ambulation with device
Historical Inquiry Post THA
WB status? Cemented, non-cemented, hybrid? Type of approach? Trochanteric Osteotamy? Intraoperative complications?
THA Mobilization
Day 1 post-op
OOB to chair mostly
Reduces wisk of DVT and Pneumonia
THA PRE’s
Submaximal Isometric for 3-5 seconds
THA Ambulation and ROM
Day 2, PROM
Posterior approach precautions
Flexion >90°
Adduction across midline
IR of hip
Anterior Approach precautions
Extension
ER
Abduction for 6-8 weeks
Anterior Approach
Interval b/w TFL and G Med with partial reflection of mm or takedown of GT
Repair of G Med follows or GT reattached
Posterolateral Approach
G. Max splitting and takedown deep ER
Posterior capsule and tendons repaired
Posterolateral Approach contraindications
Dementia, stroke, seizure disorder
Post-op instructions
Assistive Device
Positional Avoidance
Deep breathing/diaphragmatic and coughing exercises
Ankle Pumps to decrease risk of DVT
THR complications
DVT Dislocation of hip Leg length inequality Infection Loosening
THR complications
DVT Dislocation of hip Leg length inequality Infection Loosening
Outcomes of THA 1 year post-op
Significant decrease in postural stability
Congenital Coxa vara/valga
Vara is shorter limb, Valga is longer Address acute symptoms Equalize leg lengths where appropriate Address mm. imbalances Avoid high impact sports
Femoral Anteversion/Retroversion
Address Acute symptoms
Foot orthotics
Muscle performance
Legg-Calve-Perthe
Reduce the deforming forces of WB and muscle tension
Pt. often immobilized in abduction and slight IR
Crutch ambulation
Compression load intolerance training
Slipped Capital Femoral Epiphysis
Requires surgical stabilization
Post-op: ROM, strengthening, maximize function
Educate: weight control, minimal sport participation
Congenital Hip dislocation
Surgical correction or splinting
Gait training
ROM exercises
Developmental Transitioning
Fractures
WB restrictions Gait training Gentle progressive ROM PRE's Balance Training
Bursitis
Address acute symptoms
Address etiology
Muscle balance training
Structural alignment
Avascular necrosis
Usually requires surgury
OA
Maintain function Relieve symptoms Prevent deformity Education for hip joint protection principles BW reduction
