Performance milestones in postoperative physical therapy after total hip arthroplasty

Abstract Background and Purpose. The effect of physical therapy intervention on the outcomes of care for patients treated in acute care hospitals has not been widely studied. This study examined the relationship between physical therapy utilization and outcomes of care for patients following total hip arthroplasty. Subjects. The sample consisted of 7,495 patients treated in US academic health center hospitals in 1996 who survived their inpatient stay and received physical therapy interventions. Methods. The primary data source was the University HealthSystem Consortium Clinical Data Base. Physical therapy use was assessed by examining physical therapy charges. Outcomes of care were assessed in terms of the total cost of care (ie, whether the care was more costly or less costly than expected, taking into account patient characteristics) and in terms of discharge destination (ie, whether the patient was discharged home or elsewhere). Regression analyses were conducted to examine the relationship between physical therapy use and outcomes. Results. Physical therapy intervention was directly related to a total cost of care that was less than expected and to an increased probability of discharge home. Conclusion and Discussion. The results of this study provide preliminary evidence to support the use of physical therapy intervention in the acute care of patients following total hip arthroplasty and indicate the need for further study of this topic.

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Case Study: Physical Therapy Management of Hip Osteoarthritis Prior to Total Hip Arthroplasty

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.1997.26.1.35 ◽

1997 ◽

Vol 26 (1) ◽

pp. 35-38 ◽

Cited By ~ 14

Author(s):

Lorna King

Keyword(s):

Physical Therapy ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Hip Osteoarthritis ◽

Therapy Management ◽

Total Hip

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Neurovascular lesion after total hip arthroplasty in congenital hip dysplasia: Case report

Medicinski pregled ◽

10.2298/mpns1310406s ◽

2013 ◽

Vol 66 (9-10) ◽

pp. 406-410 ◽

Cited By ~ 1

Author(s):

Tatjana Stojkovic-Jovanovic ◽

Dobrivoje Martinov ◽

Ksenija Boskovic

Keyword(s):

Case Report ◽

Physical Therapy ◽

Total Hip Arthroplasty ◽

Female Patient ◽

Hip Arthroplasty ◽

Physical Treatment ◽

Vascular Surgeon ◽

Total Hip ◽

Severe Degree ◽

Vascular Status

Introduction. Nowadays, the total hip arthroplasty is a very frequent surgical intervention. In some cases, vascular and nerve injuries may happen around the hip with total hip arthroplasty. Although they are very rare, they may be very dangerous for the patient in some cases. This paper presents a case of a female patient, in whom the nervous fibularis lesion was detected after the total hip arthroplasty, and the occlusion of the iliac femoral artery was revealed later during physical therapy. Case Report. We described a case of a 32-year-old female patient, in whom the nervous fibularis lesion was detected after the total hip arthroplasty. The patient was referred to a ward for physical therapy. On the 19th postoperative day, she felt a vigorous ache and numbness on the left operated leg during stimulation of the paretic fibular musculature. Clinically weak inguinal arterial pulse was detected. After the examination, iliac-femoral occlusion was diagnosed. The patient was referred to the vascular surgeon. In the next few months, she was treated conservatively and eventually underwent surgery. The revascularization was achieved with a satisfactory effect. A year after the total hip replacement, the patient continued with rehabilitation and physical treatment, which lasted one and a half month and had an incomplete functional result - the patient walked with a walking stick and had weak fibular musculature of a severe degree. The vascular status of the leg was good. Conclusion. In this case, neurovascular lesions led to an incomplete functional recovery of the patient and compromised the expected treatment outcome. According to the scoring system used to assess the functionality, the result was marked as poor.

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Incorporating Specific Functional Strength Integration Techniques to Improve Functional Performance for Veterans After Total Hip Arthroplasty: Protocol for a Randomized Clinical Trial

Physical Therapy ◽

10.1093/ptj/pzz109 ◽

2019 ◽

Vol 99 (11) ◽

pp. 1453-1460

Author(s):

Dana L Judd ◽

Victor A Cheuy ◽

Jeri E Forster ◽

Cory L Christiansen ◽

Jennifer E Stevens-Lapsley

Keyword(s):

Clinical Trial ◽

Physical Therapy ◽

Muscle Strength ◽

Total Hip Arthroplasty ◽

Resistance Exercise ◽

Physical Function ◽

Hip Arthroplasty ◽

Functional Performance ◽

Total Hip ◽

Movement Compensation

Abstract Background Total hip arthroplasty (THA) is a common procedure, yet persistent deficits in functional performance exist after surgery. These deficits may be related to movement compensations observed after THA, which negatively affect quality of life and may increase morbidity and health care utilization, including in the veteran population. However, the best rehabilitative approach to remediating movement compensations and physical function deficits has not been determined. Objective The objective is to determine if a functional strength integration intervention (FSI), as part of a post-THA rehabilitation program, improves movement compensation, physical function, muscle strength, and self-reported outcome measures more than a control group (CON) undergoing a standard of care exercise program. Design This is a 2-arm randomized, controlled clinical trial. Setting The Veteran Affairs outpatient physical therapy clinics and academic research laboratory will be the settings. Participants One hundred veterans undergoing THA for hip osteoarthritis will be included in the study. Interventions Participants will be randomized to either the FSI or CON group and participate in visits of physical therapy over 8 weeks. The FSI protocol will include targeted exercise to improve muscular control and stability around the hip and trunk to minimize movement compensation during daily activity combined with progressive resistance exercise. The CON protocol will include patient education, flexibility activity, and low load resistance exercise. Measurements Functional performance, muscle strength and endurance, and self-reported outcomes will be measured at baseline (prior to surgery), midway through intervention (6 weeks after surgery), at the end of intervention (10 weeks after surgery), and 26 weeks after THA. Limitations The inability to blind treating therapists to study arm allocation is a limitation. Conclusions The proposed study aims to determine if targeted FSI can affect movement compensation to improve functional outcomes after THA more than traditional rehabilitation paradigms.

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