Patient will attend physical therapy 23xweek for the first 6 weeks. This illustrated guide includes exercises and activities designed to restore strength and mobility to your hip following total hip replacement. May 01, 2011 when conservative treatment fails to alleviate pain and dysfunction of the hip caused by osteoarthritis oa, total hip arthroplasty tha is a costeffective surgical treatment that can provide significant pain relief and improvement in physical functioning. This was written and developed by the therapists of mgh physical therapy services. Initial phase weeks walking at home for about 5 minutes every hour bike for approximately 10 minutes quad sets glut sets. This procedure replaces your damaged hip joint with an artificial hip implant. Begin flexion, ir, er, and elevation in scapular plane, submaximal painfree shoulder isometrics in neutral, progress scapular and distal extremity strengthening. Total hip arthroplasty physiotherapy protocol total hip arthroplasty physiotherapy protocol. Individual circumstances may result in variations of the information below.
Sling worn continuously for 34 weeks, no shoulder arom, no lifting of objects. When conservative treatment fails to alleviate pain and dysfunction of the hip caused by osteoarthritis oa, total hip arthroplasty tha is a costeffective surgical treatment that can provide significant pain relief and improvement in physical functioning. The protocol was generally developed from previous highintensity and progressive rehabilitation that have been used after total knee arthroplasty. Reduce pain, inflammation and muscular inhibition, increase prom of shoulder, allow healing of soft tissue. Promote hip extension, by lying in prone if possible, to prevent a hip flex contracture. Institute for orthopaedic surgerys physical and occupational therapy protocols.
Total hip arthroplasty lateral approach rehab protocol. Formal physical therapy after total hip arthroplasty is not. Total hip replacement protocol posterior approach penrose. Reacher and grabber devices to be used for retrieving objects on floor or assist with socks or. Immediately after your thr surgery, a physical therapist will likely visit you in your hospital room. Recovery of physical functioning after total hip arthroplasty. Initially, supportive devices such as a walker or crutches are used. Formal physical therapy after total hip arthroplasty is. Posteriordirect total hip arthroplasty rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Anterior total hip arthroplasty protocol postop weeks 26 weeks 612 initial evaluation evaluate history of injury premorbid activity level aromprom incisional integrity. Hold the leg lift for a count of five, then return to the starting position. Total hip arthroplasty tha, also known as a total hip replacement is an elective surgical. General time frames are given for reference to the average, but individual patients will progress at different rates depending on their age, comorbidities, presurgical range of motion, strength.
Physical therapy is an essential part of rehabilitation after a total hip replacement. Complications and risks of total hip replacement surgery have been identified. Hip flexion 090, hip abduction 030, independent in transfers and ambulation for 100 feet w assistive device phase ii. The purpose of this protocol is to provide the home health physical therapist and physical therapist assistant guidance in advancing a patient through the second of the three phases of therapy for patients who have undergone a primary total hip arthroplasty. Total hip arthroplasty physical therapy protocol jovan r. It was developed with input from the clinic director, licensed therapists who treat patients after tha. It is designed for rehabilitation following a posterior approach total hip arthroplasty. Total hip replacement rehabilitation protocol outpatient physical therapyphase i weeks 1 6 postop patient is evaluated weekly in outpatient pt unless deemed otherwise, or in inpatient setting evaluate and document.
Total hip replacement rehabilitation protocol outpatient physical therapy phase i weeks 1 6 postop patient is evaluated weekly in outpatient pt unless deemed otherwise, or in inpatient setting evaluate and document. Total hip arthroplasty direct anterior approach rehab protocol. This usually consists of a series of outpatient appointments with a physical therapist. This blood can be used for transfusion if needed autologous transfusion. Patients also learn how to walk with crutches, or a. Whatever setting you are in after your thr, from the hospital or the outpatient clinic, a physical therapist can help you get back to your normal lifestyle along the way. We strongly recommend you to find a qualified physiotherapist. Total knee arthroplasty protocol brigham and womens.
Physical therapy standards of care and protocol the following standards of care and protocols are the property of bwh and should not be copied or otherwise used without the permission of the director of rehabilitation services. Rehabilitation guidelines for total hip anterior arthroplasty these rehabilitation guidelines are presented in a criterionbased progression. It is designed for rehabilitation following an anterior approach total hip arthroplasty. To begin, your doctor will follow the line of the incision made during your primary total hip replacement. Total shoulder arthroplasty or resurfacing hemiarthroplasty outpatient therapy protocol. Total hip arthroplasty direct anterior approach rehab. The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total. Rock weight back and forth over the surgical leg keeping the knee straight. Total hip replacement exercise guide orthoinfo aaos.
Avoid and educate patient upon risky extreme positions for dislocation. This protocol applies to the routine primary total hip arthroplasty procedure. Sling only to be worn while sleeping, no lifting of objects heavier than a coffee cup, no sudden movements, pillow to be placed under elbow when in supine. Revision total hip replacement is a more complex procedure and takes longer to perform than primary total hip replacement. Jan 23, 2018 total hip arthroplasty tha has been a successful, increasing practice for caring for hip arthritis in the aging and active population. Eventually, rehabilitation incorporates stepping, walking, and climbing. The specific exercises given in this protocol are provided for guidance, but it is important to use.
One high standard, three local partners for more information go to. Health survey, tha total hip arthroplasty, thap total hip arthroplasty protocol, thapcp total hip arthroplasty physiotherapy care protocol. Holding onto the walker, place your surgical leg behind you. Total hip arthroplastyhemiarthroplasty rehab protocolbrigham and womans hospital. With substantial changes that have occurred in surgical and anesthesia techniques, selfdirected therapy may be efficacious in restoring function to patients undergoing total hip arthroplasty. Department of rehabilitation services reverse total. Physical therapy guidelines for total ankle arthroplasty. The above mention hip replacement rehabilitation protocol should be tailored to individual patients need and performed in guidance of a physical therapist. Total hip arthroplastyhemiarthroplasty rehab protocol. Exercise program for total hip replacement vch patient health. Total knee arthoplasty tka or total knee replacement tkr is a orthopaedic surgical procedure where the articular surfaces of the knee joint the femoral condyles and tibial plateau are replaced. Preoperative banking of the blood of patients planning total hip replacement is considered when possible.
Archives of physical medicine and rehabilitation 2008. Posteriordirect total hip arthroplasty rehabilitation. Outpatient physical therapy is usually your final step before returning to full function after a total hip replacement. After total hip joint replacement surgery, patients often start physical therapy immediately. Physical therapy management of total hip arthroplasty. Do not bend forward at the hip keep your trunk upright. The tendency is for the knee on the surgical leg to. Understanding of preop exercises, instructions, and overall. November 23, 2016 uncategorized physio4fight, physioforfight, physiotherapy, total hip arthroplasty physiotherapy protocol physio4fight. This evidencebased anterior total hip arthroplasty guideline is criterionbased. Keeping your knee straight, lift the leg backwards from the hip. Despite all that, after discharge from the hospital, the physical therapy visits seemed to go on forever. Patient will attend physical therapy 23xweek for the first 6 weeks or until patient returns to the surgeon.
It was called the operation of the century in an article published in the lancet in 2007, as a result of the excellent outcomes achieved. Posteriordirect total hip arthroplasty rehabilitation guideline. Home health physical therapy protocol total hip arthroplasty tha page 1 of 4 purpose. Stairs with a reciprocal pattern and no railing to assist to ascend. There is at least one polyethylene piece, placed between the tibia and the femur, as a shock absorber. Total ankle arthroplasty physical therapy protocol 02 weeks non weight bearing in splint. Patients learn an initial postoperative set of exercises, including isometric and active range of motion exercises. Gait c orrect any abnormal gait patterns noted hip rom s tay within the precaution limits hip strength. Physical therapy protocols hip arthroscopy protocol.
Total hip arthroplasty physiotherapy protocol physio4fight. Hip implants consist of 1 a smooth ball on a stem that fits into your thigh bone the femoral stem, and 2 a. The protocol listed below is adopted from a protocol developed by the brigham and womens hospital department of rehabilitation services. Anterior total hip arthroplasty rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Anterior total hip arthroplasty rehabilitation guideline. Rehabilitation guidelines for total hip anterior arthroplasty. Minimal to no reactive pain and swelling with adls and pt exercises. Total shoulder arthroplasty hemiarthroplasty protocol. Encourage a straight line from the shoulder to knee. The value of formal physical therapy after total hip arthroplasty is unknown. In fact, its routine after hip replacement surgery to have extensive physical therapy also called rehabilitation therapy, or rehab.
Standing hip extension 1 use a chair or counter for support. Normally, the hip functions as a ballandsocket joint. Total hip replacement protocol northwestern medical center. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral head replacement, hhr. Total hip replacement is a surgical procedure that replaces the hip joint with artificial parts called prostheses. Appointments start physical therapy 3 5 days post surgery 23x per week rehabilitation goals follow rom precautions set by md restore rom as allowed by precautions normalize gait pattern. It is not intended to be a substitute for appropriate. Appointments start physical therapy 3 5 days post surgery 23x per week rehabilitation goals follow rom precautions set by md restore rom as allowed by precautions. On the first day after surgery, it is common to begin some minor physical therapy while sitting in a chair. Total hip arthroplasty tha is an elective operative procedure to treat an arthritic hip. Total hip arthroplasty direct anterior approach rehab protocol last revision. Westover hills orthopaedics 11212 state highway 151 medical plaza ii, suite 250 san antonio, tx 78251 tel 2107039758 fax 2107039759 total hip arthroplasty hemiarthroplasty. Hip implants consist of 1 a smooth ball on a stem that fits into your thigh bone the femoral stem, and 2 a metal socket with a smooth liner that is attached to. These exercises may be suitable for patients with a different surgical approach, bilateral total hip replacements, revisions or for inflammatory conditions.
Address all correspondence to carlos roberto galia, phd. Muscle strengthening of entire hip girdle, begin proprioceptive training, continue with gait, endurance, and functional training and mobility. Gait reeducation with mobility assestive device crutches vs walking frame vs rollator. This protocol is broken down into 4 phases, acute, motion, intermediate, and advanced strengthening and higher level function stage. Total hip arthroplasty lateral approach rehab protocol last revision. Sitlie with knee straight arom hip and knee 26 weeks 2 week md visit. Arom gradually and in protected range no hip flex 90 add to neutral. Independent with ambulation with assistive devices as needed a. Physical therapist to coordinate patient receiving appropriate assistive device for. Recommended longterm activities after total hip replacement. The most common cause of hip joint deterioration is osteoarthritis. Reacher and grabber devices to be used for retrieving objects on floor or assist with socks or stockings. Department of rehabilitation services reverse total shoulder. The top of the thigh femur bone ball fits into a part of the pelvis called the acetabulum socket, allowing the joint to move smoothly in multiple directions.
Proposed rehab protocol for total knee replacement. Stand from chair without upper extremity assistance dc instructions from the hospital. Physical therapy standards of care brigham and womens. Lowfrequency electric muscle stimulation combined with physical therapy after total hip arthroplasty for hip osteoarthritis in elderly patients. The intent of this physical therapy protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient who has undergone a total knee arthroplasty tka at brigham and womens hospital bwh. Precautions after total hip replacement following points must be explained clearly during hip replacement rehabilitation. It was first performed in the 1960s and is said to be one of the most successful surgeries in the last few decades. Treatment will follow the defined protocol below and be carried out by physical therapist, athletic trainer andor physical therapy assistants. The advent of new techniques and efficiency has advanced the practice to one of the more reproducible and beneficial operations orthopaedic surgeons perform. Physical therapy protocol total hip replacement and hip resurfacing please instruct patients on safe methods of ambulation, sitting, reaching, bathing and personal care. A total hip replacement is a surgical procedure in which both damaged surfaces of the hip joint are replaced with prosthetic substitutes. Total hip arthroplasty protocol page 2 of 3 total hip arthroplasty protocol phase 1. Hip replacement rehabilitation physiotherapy treatment.