Total Hip Replacement: Difference between revisions
No edit summary |
No edit summary |
||
| Line 42: | Line 42: | ||
== Medical Management <br> == | == Medical Management <br> == | ||
Many surgical approaches for THR are described but we can resume them to anterior, lateral and posterior approach. These approaches determine the amount of soft tissue damaged. Many surgeons are changing from a posterior approach to a more anterior one. Cadaveric studies show that this type of approach is less invasive and damaging for muscles, capsules, ligaments and nerves<ref name="Oldenrijk">Van Oldenrijk J. et al., Soft tissue damage after minimally invasive THA. Acta orthopaedica 2010; 81 (6): 696-702</ref><ref name="Zhang">Zhang X. et al. Anterolateral muscle sparing approach total hip arthroplasty: an anatomic and clinical study. Chinese Medecine Journal 2008; 121 (15):1358-1363</ref>. Other studies have shown a better rehabilitation time and functional outcome<ref name="Röttinger">Röttinger H. Minimally invasise anterolateral approach for total hip replacement.,Operative Orthopädie und Traumatologie (4)</ref>. Because of the lowered risk of dislocation compared to a posterior approach<ref>Sköldenberg O. et al. Reduced dislocation rate after hip arthroplasty for femoral neck fractures when changing posterolateral to anterolateral approach. Acta Orthopaedica 2010; 81 (5): 583-587</ref>, early mobilizations as well as full weight bearing exercises according to tolerance are made possible in the first postoperative days<ref name="Röttinger" />.<br>The articulating couples (head and cup) used by surgeons are made of metal-on-polyethylene (PE), ceramic-on-PE, metal-on-metal and ceramic-on-ceramic<ref>http://orthopedics.about.com/od/hipkneereplacement/a/implants.htm</ref>. Important components of prosthesis are friction-coefficient, survival, stability against dislocation and fixation in bone tissue<ref name="Bader">Bader R. et al. Differences between the wear couples metal-on-polyethylene and ceramic-on-ceramic in the stability of dislocation of total hip replacement. Journal of materials science: materials in medicine 2004; 15:711-718</ref><ref name="Garcia">Garcia-Rey E. et al. Alumina-on-alumina total hip arthroplasty in young patients. Clinical Orthopaedics and Related Research; 467 (9):2281-2289</ref>. In some cases there can be formation of osteonecrosis due to erosion of the two components rubbing against each other<ref name="Mahendra">Mahendra G. et al. Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties. Acta Orthopaedica 2009; 80 (6): 653-659.</ref>.<br><br> | |||
== Physical Therapy Management <br> == | == Physical Therapy Management <br> == | ||
Revision as of 19:29, 18 January 2011
Original Editors - Annelies Beckers, Vincent Everaert
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Search Strategy[edit | edit source]
add text here related to databases searched, keywords, and search timeline
Definition/Description[edit | edit source]
add text here
Clinically Relevant Anatomy[edit | edit source]
add text here
Epidemiology /Etiology[edit | edit source]
add text here
Characteristics/Clinical Presentation[edit | edit source]
add text here
Differential Diagnosis[edit | edit source]
add text here
Diagnostic Procedures[edit | edit source]
add text here related to medical diagnostic procedures
Outcome Measures[edit | edit source]
add links to outcome measures here (also see Outcome Measures Database)
Examination[edit | edit source]
The task of a physical therapist consists before the operation of investigating the muscular state (force, volume), ROM and the circulatory state of the injured as well as the healthy limb [1] . This gives an idea of the preoperative state of the patient.
The general physical and psychological state of the patient should also be taken care of.
For example explaining the surgical technique and the therapeutic monitoring after surgery can help lowering the patient’s anxiety. Explaining how to use a rollator or walk on crutches properly can also make the patient more self-confident when entering the postoperative stage of the therapy[1].
Medical Management
[edit | edit source]
Many surgical approaches for THR are described but we can resume them to anterior, lateral and posterior approach. These approaches determine the amount of soft tissue damaged. Many surgeons are changing from a posterior approach to a more anterior one. Cadaveric studies show that this type of approach is less invasive and damaging for muscles, capsules, ligaments and nerves[2][3]. Other studies have shown a better rehabilitation time and functional outcome[4]. Because of the lowered risk of dislocation compared to a posterior approach[5], early mobilizations as well as full weight bearing exercises according to tolerance are made possible in the first postoperative days[4].
The articulating couples (head and cup) used by surgeons are made of metal-on-polyethylene (PE), ceramic-on-PE, metal-on-metal and ceramic-on-ceramic[6]. Important components of prosthesis are friction-coefficient, survival, stability against dislocation and fixation in bone tissue[7][8]. In some cases there can be formation of osteonecrosis due to erosion of the two components rubbing against each other[9].
Physical Therapy Management
[edit | edit source]
add text here
Key Research[edit | edit source]
add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)
Resources
[edit | edit source]
add appropriate resources here
Clinical Bottom Line[edit | edit source]
add text here
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
Extension:RSS -- Error: Not a valid URL: Feed goes here!!|charset=UTF-8|short|max=10
References[edit | edit source]
see adding references tutorial.
- ↑ 1.0 1.1 Raymond Sohier, Kinesitherapie de la hanche ; La Hestre : Sohier, 1974
- ↑ Van Oldenrijk J. et al., Soft tissue damage after minimally invasive THA. Acta orthopaedica 2010; 81 (6): 696-702
- ↑ Zhang X. et al. Anterolateral muscle sparing approach total hip arthroplasty: an anatomic and clinical study. Chinese Medecine Journal 2008; 121 (15):1358-1363
- ↑ 4.0 4.1 Röttinger H. Minimally invasise anterolateral approach for total hip replacement.,Operative Orthopädie und Traumatologie (4)
- ↑ Sköldenberg O. et al. Reduced dislocation rate after hip arthroplasty for femoral neck fractures when changing posterolateral to anterolateral approach. Acta Orthopaedica 2010; 81 (5): 583-587
- ↑ http://orthopedics.about.com/od/hipkneereplacement/a/implants.htm
- ↑ Bader R. et al. Differences between the wear couples metal-on-polyethylene and ceramic-on-ceramic in the stability of dislocation of total hip replacement. Journal of materials science: materials in medicine 2004; 15:711-718
- ↑ Garcia-Rey E. et al. Alumina-on-alumina total hip arthroplasty in young patients. Clinical Orthopaedics and Related Research; 467 (9):2281-2289
- ↑ Mahendra G. et al. Necrotic and inflammatory changes in metal-on-metal resurfacing hip arthroplasties. Acta Orthopaedica 2009; 80 (6): 653-659.
