Physical Therapy Today: Pre- and post-operative physical therpy for total hip replacement

Total hip replacement (THR) is a surgical procedure to replace a damaged hip joint with a new artificial/prosthetic implant. Physical therapy is essential before and after surgery in order to minimize complications. Therapy also reduces recovery time and restores hip joint function as quickly as possible.

Musculo-skeletal conditions

that may require THR

An impaired hip joint can result in pain and motion restriction for daily activities like sitting, standing, walking and commuting. Some of the conditions that could potentially damage the hip joint include:

• Trauma

• Tumors

• Osteoarthritis

• Rheumatoid arthritis

• Osteonecrosis

Signs and symptoms include moderate to severe hip pain and joint stiffness. Since the hip is a weight-bearing joint, pain and discomfort in this region can interfere with the ability to walk and result in gait imbalances.

Imbalances can trigger several biomechanical adjustments in the lower body and lead to low back pain, knee pain and ankle pain. Over a period, this can cause several limitations in function. It’s important to consult with a physician and detect hip joint abnormalities as soon as possible to prevent long-term damage.

BENEFITS OF PHYSICAL THERAPY

In the event of a scheduled THR surgery, physical therapy can speed up healing and rehabilitation of the hip joint before and after surgery.

Before surgery

A baseline measurement of the strength and flexibility may be performed. The patient is educated about precautions to take prior to the surgery and positions/movements to avoid after surgery. Physical therapy can help with pain control prior to surgery by using gentle exercises, heat, and/or massage, to name a few.

After surgery

Several procedures and modalities can be used by the physical therapist to facilitate recovery after surgery.

These include:

• ultrasound to heal connective tissue (tendons and ligaments)

• manual therapy that includes stretching, joint mobilization, and soft tissue work

• resistance training to build muscle strength

• cold compress and heat to relax muscle spasms

• low-level laser use for muscle and connective tissue injuries

• functional electrical stimulation to restore muscle strength

THE IMPORTANCE OF

THE INITIAL EVALUATION

Your physical therapist understands that when it comes to your recovery, every little detail matters. That is the reason your therapist will conduct a detailed initial evaluation. This includes objective measurements of the strength, flexibility, and mobility of the hip joints.

The physical therapist will identify functional limitations of the patient and establish a gap between the prior level of function and intended level of function.

Once the physical therapist determines this gap and analyzes diagnostic tests like X-rays and MRI scans, an effective treatment program can be created. This consists of specific procedures and modalities.

Treatment for mild hip problems is generally conservative. It includes medications and physical therapy. Physical therapy can also help before and after THR surgery. After a brief period of hospitalization, the patient may need several weeks, potentially months of physical therapy to achieve full recovery.

Casey Cortney, MPT is a licensed physical therapist and owner of Sidney Rehabilitation & Wellness Clinic. Casey can be reached at 308-254-4979 or by visiting the website at http://www.sidneyrehab.com.