Total Hip Arthroplasty CAT

Question 1

What conditions are indications for THA?

Answer 1

• Progressive and severe hip OA or RA
• Developmental hip dysplasia
• Tumors
• Trauma
• Avascular necrosis

Question 2

Contributing factors to needing THA

Answer 2

• Arthritis
• Repetitive microtrauma
• Obesity
• Nutritional imbalances
• Falls
• Abnormal joint mechanics

Question 3

Clinical presentation for a pt needing THA

Answer 3

• Decreased ROM
• Impaired mobility
• Persistent pain w/ motion and WB
• 55+ y/o

Question 4

Labs/imaging for THA

Answer 4

X-ray, CT, MRI to view joint and rule out tumor

Question 5

Post-surgical complications w/ THA

Answer 5

• Nerve injury
• Vascular damage
• Dislocation
• Pulmonary embolism
• MI
• CVA
• Prosthesis can get loose, infected, heterotopic ossification,
• Fx

Question 6

Movements to avoid for posterior approach THA

Answer 6

• Avoid hip flexion >90 degrees, hip adduction, hip IR
• More susceptible to post-op instability

Question 7

Movements to avoid for anterolateral approach THA

Answer 7

Avoid hip extension, ER, and adduction

Question 8

What is done with a direct lateral approach THA?

Answer 8

• Leaves posterior portion of glute med attached to greater trochanter
• Leaves posterior capsule intect

Question 9

Why would a direct lateral approach THA be used?

Answer 9

If the patient is likely to be noncompliant in order to avoid posterior dislocation

Question 10

Pharmacological management of THA

Answer 10

• Anticoagulants
• Pain meds

Question 11

PT management of THA

Answer 11

• Hip protocol exercises initially
• Education for hip precautions, WB status, scar management, and STM
• Early ambulation training
• Progress to walking w/ cane

Question 12

Goal for ROM at hospital discharge post-THA

Answer 12

Neutral hip extension, 90 degrees hip flexion

Question 13

WB status initially for cemented hip replacement

Answer 13

• Partial WB

Question 14

WB status initially for noncemented hip replacement

Answer 14

Toe touch WB for up to 6 weeks

Question 15

How long should a patient adhere to hip precautions post-THA?

Answer 15

• Minimum 3 months OR
• Physician determines adequate hip stability