Posterior Approach to the Total Hip Replacement Surgery – Surgery&Rehabilitation Example

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"Posterior Approach to the Total Hip Replacement Surgery" is a great example of a paper on surgery and rehabilitation.   Description of the procedure                       Posterior approach to total hip replacement surgery is currently one of the commonly used orthopaedic hip replacement procedures. When using a posterior approach, surgeons performing hip replacement procedures normally access the hip joint using a small incision made close to the buttocks. This particular ensures that the main abductors (walking muscles) are not disrupted during the operation. The small tendons behind the hip joint are then carefully detached to allow the surgeon to access the hip joint capsule.

In this regard, both the tendons and the hip joint capsule can be later reattached after the operation. According to Masonis and Bourne (47), the key benefits of the posterior approach include high success rate, minimal disruption of abductor muscles and reduced complication rates. On the other hand, some of the main contraindications of this procedure include avoiding hip flexion that is greater than 90 degrees as well as any hip internal rotation beyond neutral. Rehabilitation protocol The rehabilitation protocol of posterior approach total hip replacement surgery involves a number of rehabilitation phases that run from week 1 up to the 6th month after the operation.

Generally, the rehabilitation phases are meant to minimize the risks of post-operation hip dislocation and other related injuries to the patient. Week 1-6                       The main goal for this rehabilitation phase is to achieve maximum protection of the hip joint after the operation by limiting hip rotation to less than 90 degrees. One of the key interventions during this phase is ensuring the patient walk with crutches to help minimize the weight being exerted on the healing hip joint.

Gradual isometric exercises can also help in the progressive abductor stretching. The interventions to avoid during this period include any activities that may result in internal rotation and combined motion of the hip flexion. Week 6-9                       The goal of this phase is to ensure that the patient achieves normal gait. In this regard, the specific interventions include walking with a cane, sleeping on the back, avoiding hip flexion greater than 90 degrees and retro walking in parallel bars (Pellicci and Bostrom, 225).

The patient should also begin to undertake regular treadmilling exercises and other related walking progression programs. Interventions to be avoided during this phase include performing high impact exercises. In order to proceed to the next phase, the patient should undertake the full transition from crutches to cane. Week 9-12                       This period is the final phase of the rehabilitation process for the post-posterior approach to total hip replacement surgery. Some of the goals of this phase include achieving symmetrical hip ROM, making sure the patient is able to walk for 20 minutes or stand from sitting without using hands.

Interventions during this phase involve measures such as practising sit-stand exercises without the use of hands, stair training and carrying out minimal proprioception exercises. By the end of this phase, the patient should be able to resume most of the recreational activities that can be tolerated as well as participate in other non-impact physical activities.

References

Masonis, John L and Bourne R. Boat. Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop 405.4(2002): 46-53.Print.

Pellicci, Paul. M and Bostrom M. Cathy. Posterior approach to total hip replacement using enhanced posterior soft tissue repair. Clin Orthop 355(1998): 224-228.Print.

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