9 Enormous Hip Spacer precautions Physical Therapy Tips to Minimize Risk

Following total Hip Replacement surgery, hip spacer precautions physical therapy are an important part of standard postoperative care. Depending on one’s mobility and health, some hip spacer precautions physical therapy may be required for as long as six months. These hip spacer precautions physical therapy are only applicable to the posterior or posterior-lateral hip replacement procedure. There are fewer precautions for anterior hip replacement procedures, and these will be discussed later in this article.

Introduction and Case studies to hip spacer precautions physical therapy

Description of the Case: A 66-year-old male presented to ED complaining of rigors and RLE pain. For right THR and cardiac arrhythmias, it was important to have a history. Fluid cultures revealed that the patient had sepsis secondary right hip abscess. The patient was transferred to the medical ICU and an articulating cement antibiotic hip spacing was used to replace the infected hardware. Due to hemodynamic instability, the patient was kept intubated and sedated for nine days after surgery. Post-op, the PT intervention focused on chest PT and ROM as well as bed mobility.

It also addressed strategies to reduce ICU-acquired delusions. Daily use of the Confusion Assessment Method (CAM), was required to determine if there was delirium. Initial mobility was restricted and delayed by a conflicting weight-bearing order from the surgeon team. In the end, the patient status was confirmed to be WBAT. The patient was seen for 1-2 sessions each day, seven days a week.

Results: The patient responded positively to early mobility, despite ongoing delirium-challenging progress. After a 40-day stay in ICU, the patient was functionally able to move 120 feet with a rollator and CGA. Based on the CAM score, the patient’s condition improved over the course of the PT intervention.

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hip spacer precautions physical therapy

General Rule

  • When sitting, standing, or lying down, don’t cross your legs or ankles.
  • Do not bend your leg more than 90 degrees.
  • You must extend your operated leg forward when you are sitting, standing, or standing from a toilet seat, chair or bed.

Dressing

  • If your bed is stable, don’t stand while you are dressing. You can sit on the edge of your bed or in a chair.
  • Dressing up should not be done in a way that requires you to bend, lift or cross your legs.
  • A reacher, a long-handled shoehorn, or socks can be used as an aid in putting on your shoes.
  • Make sure you undress on the side that is not in use during surgery.

Sitting

  • Do not sit in one position for too long. You can move around every 30 minutes.
  • Make sure your feet are at least 6 inches (15 cm) apart
  • Don’t cross your legs
  • Avoid using cushion chairs, rocking chairs, stools, or sofas. You should sit in a comfortable chair with straight backs and armrests.
  • Avoid sitting in low chairs, and if you must, get a pillow.

Bathing/Toileting

  • You can use a tub seat to sit in the shower
  • Rubber mats can be used on the bathtub or shower floor. Keep the bathroom floor dry and clean
  • Showering is a time to bend, squat, and reach for anything. You can use a long-handled shower sponge to wash any parts of your body that are difficult.
  • Use an elevated toilet seat. You should use an elevated toilet seat.

Ascending/Descending stairs

  • Ascend with the unaffected leg (the one that has not been operated on).
  • Step first with the leg you have had surgery on when you descend.

Lying down in bed

  • You should not lie on your stomach or on your hip. If you’re sleeping on your stomach, make sure you have two pillows between your legs.

How to get into/ride a car

  • You should always get in the car from the street, and not from a curb or doorstep.
  • Make sure the car is not too low. If necessary, you can use a pillow.
  • Do not take long car rides. Instead, walk every two hours.

Walking

  • Use your walker or crutches until your doctor or physical therapist says it is okay to stop.
  • Don’t put on more weight than your doctor or physical therapist has advised you to for the operation hip.
  • Make small steps every time you turn.
  • Slippers can cause you to fall. When walking on uneven or wet surfaces, be careful.

hip spacer precautions physical therapy for the anterior hip approach

This approach is more flexible

  • With a surgical leg, do not go backward. No hip extension.
  • Don’t allow the surgical leg to turn outwards (externally rotate)
  • Don’t Cross your legs. Rolling with a pillow between your legs is a good idea.
  • If you are side-living, sleep on your surgical side.

Evidence regarding hip spacer precautions physical therapy

Recent studies have raised questions about the use of hip spacer precautions physical therapy. According to a 2017 study, Routine hip spacer precautions physical therapy in primary settings are unnecessary and possibly harmful. In anterior lateral THR, the dislocation rate is low. Hip spacer precautions physical therapy do not improve this result according to a systematic review. These hip spacer precautions physical therapy can lead to a slower return to activity, substantial expense, and lower patient satisfaction.

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Discussion:

Continual fluctuating delirium over a 31-day period slowed the progression of functional mobility. Treatment barriers included patient cognition, hemodynamic instability, conflicting weight bearing, and the absence of established mobility guidelines. Despite these barriers, strategies that addressed delirium and early mobility led to positive functional outcomes as well as improved mental health. This case illustrates the potential for early mobility to restore function in patients with ICU-acquired delirium.

Study resources:

https://sunnybrook.ca/content/?page=musculoskeletal-hip-replacement-hip-precautions

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