Total Hip Arthroplasty CAT Flashcards
What conditions are indications for THA?
- Progressive and severe hip OA or RA
- Developmental hip dysplasia
- Tumors
- Trauma
- Avascular necrosis
Contributing factors to needing THA
- Arthritis
- Repetitive microtrauma
- Obesity
- Nutritional imbalances
- Falls
- Abnormal joint mechanics
Clinical presentation for a pt needing THA
- Decreased ROM
- Impaired mobility
- Persistent pain w/ motion and WB
- 55+ y/o
Labs/imaging for THA
X-ray, CT, MRI to view joint and rule out tumor
Post-surgical complications w/ THA
- Nerve injury
- Vascular damage
- Dislocation
- Pulmonary embolism
- MI
- CVA
- Prosthesis can get loose, infected, heterotopic ossification,
- Fx
Movements to avoid for posterior approach THA
- Avoid hip flexion >90 degrees, hip adduction, hip IR
- More susceptible to post-op instability
Movements to avoid for anterolateral approach THA
Avoid hip extension, ER, and adduction
What is done with a direct lateral approach THA?
- Leaves posterior portion of glute med attached to greater trochanter
- Leaves posterior capsule intect
Why would a direct lateral approach THA be used?
If the patient is likely to be noncompliant in order to avoid posterior dislocation
Pharmacological management of THA
- Anticoagulants
- Pain meds
PT management of THA
- Hip protocol exercises initially
- Education for hip precautions, WB status, scar management, and STM
- Early ambulation training
- Progress to walking w/ cane
Goal for ROM at hospital discharge post-THA
Neutral hip extension, 90 degrees hip flexion
WB status initially for cemented hip replacement
- Partial WB
WB status initially for noncemented hip replacement
Toe touch WB for up to 6 weeks
How long should a patient adhere to hip precautions post-THA?
- Minimum 3 months OR
- Physician determines adequate hip stability
