Date of Award

2010

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Mark Romanick

Keywords

Arthroplasty, Replacement, Hip -- rehabilitation; Case Reports

Abstract

Background and Purpose: This article describes the acute care physical therapy management of an 88 year old female who underwent elective left posterior lateral approach total hip arthroplasty surgery. The patient was seen post-operative day one presenting with extreme pain, decreased functional mobility, and decreased range of motion and strength. Total hip arthroplasty has become a common surgery among the elder population to improve their functional and decrease pain occurring in their hip. The purpose of this article is to describe the interventions used with this patient, such as bed exercises, ambulation, and the functional outcome.

Case Description: This patient suffered severe pain and decreased function due to osteoarthritis in her left hip joint. Conservative treatment did not help improve any of her signs and symptoms.

Intervention: The treatment of this patient included therapeutic exercises, bed mobility, transfer and gait training, functional activities, and education on precautions and protocol for this type of surgery.

Outcomes: Following acute care physical therapy intervention, the patient achieved independent transfer abilities including bed, chair, and commode; decreased pain, increased strength and range of motion and independence with her home exercise program. The patient was able to ambulate with a front wheeled walker 25 meters with contact guard assist of one while achieving equal step lengths.

Discussion: Rationale for treatment was based on the surgeon’s protocol and supporting evidence on the treatment of patients with total joint replacements. Treatment was progressed and adjusted based on patient’s response. The outcomes with this specific patient were less than optimal due to decreased motivation from patient.

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