Total Hip Replacement
Post Rehab Goals and Objectives:
- Improve Overall Leg Strength
- Improve Functional Capacity
- Full Weight Bearing
- Improve Gluteal Strength
Description
The hip has three degrees of freedom or mobility. This means the hip has three planes of movement. This movement into flexion/extension, abduction/adduction and internal/external rotation. The hip is the largest and strongest joint in the body. The hip derives it support from the deep hip rotators, and the ball and socket orientation of the joint. Degenerative changes may occur in the hip. These changes are due to wear and tear from stair climbing, running, normal walking and lifting. The degenerative changes are result of insult and injury to the hyaline cartilage covering the joint surfaces. Arthritic changes in the hip and/or fracture of the femur head may lead to total hip replacement.
Total hip replacement (THR) procedure usually involves the removal of the femur head, neck and restructuring the acetabulum. The anatomical structures are replaced with surgical implants or prostheses. The prostheses are made of a titanium alloy. These implants usually last about 10 years.
Immediately after surgery the client is referred to physical therapy for gait training, lower extremity strength and ADL training. After discharge from physical therapy a supervised fitness program allows the client to maintain/ improve the level of function and independence achieved through physical therapy. Throughout physical therapy and the supervised fitness program, the client should avoid a combination of hip flexion beyond 90 degrees, hip adduction across the midline of the body and internal rotation. This combination may result in hip dislocation. Any of these movements to an extreme may also cause dislocation.
The THR client usually completes a long cycle of physical therapy and medication before surgery is performed. The management of the client focuses on the return of functional strength as quickly as possible after surgery. Within hours of the surgery the client begins therapy. The immediate goal after surgery is independent ambulation with an assistive device.