Total Hip Replacement

Question 1

THJR post op day 1

Answer 1

• Review hip precautions
• Chest Physio, circulation exercises
• ROM exercises hip/knee/ankle unaffected leg
• Bed exercises operated leg AAROM • Static quads
• IRQ
• Hip and Knee flexion
• Hip abduction, extension

Question 2

THJR post op day 2, 3 - D/c

Answer 2

Continue chest physio, circulation exercises as
indicated, bed exercises
Mobilise: progress mobility distance
Standing exercises (hip flexion, abduction, adduction not past midline, extension) and supported mini squat/STS
Stairs +/- car transfers
D/C: independent bed mobility, mobility, stairs

Question 3

Hip precautions

Answer 3

Posterior or lateral approach
No flexion past 90°
No crossing legs/adduction past midline
No twisting or IR

Anterior approach No extension
No external rotation No adduction past midline

Question 4

Hip Dislocation

Answer 4

Uncommon 6-7%
More common with posterior/lateral approach, females, prev. surgery
Greatest risk in first few months
Popping sound, severe pain
Change in leg length, internal rotation of hip
Inability to weight bear
58-70%riskofreoccurrence

Question 5

Management of dislocation

Answer 5

Closed reduction
Hip abduction brace Hip spica
Further surgery
Revision head and liner exchange Insertion of constrained component