Download Chapin Guiliante Dr. Glumac PT 100 Computer Library Project

Chapin Guiliante
Dr. Glumac
PT 100 Computer Library Project
Geriatrics Dealing with a Hip Replacement
Geriatrics refers to the health of old people, and in older people health is on the
downfall. Some elders may have great health, but there muscle tone may start
deteriorating. Whenever people lose their muscle tone, it is harder for them to support their
body. This is the reasoning behind the fact that older age increases risk for falls. About
30% of people aged 65 and older have a fall each year. Over half of these falls end up
causing an injury.1 When falling, most people tend to try to catch themselves on the side of
their body. The elderly do not have the muscle tone to be able to support the body as they
plummet to the ground. This can cause many problems, but the highest fall incident occurs
with the hips.
A study has shown that approximately 60% of physical therapy sessions were
patients who had hip fractures.2 There are a few signs of a hip fracture, and they include
severe pain, shortening and external rotation of the limb, and the loss of mobility.3 The
severity of the fracture depends on the treatment at which the patient will follow through
with. Some elderly people who do not have a tremendous amount of pain and are confined
to a wheelchair will not have surgery performed. In most other cases, they will have some
sort of surgery. Along with the fracture, a lot of elders will suffer from osteoarthritis which is
the degeneration of cartilage. This can cause a great amount of pain and stiffness to the
patient. Fractures and osteoarthritis are the two main reasons for a total hip replacement to
be performed.2 The surgeons perform the surgery by removing the damaged tissue that is
causing the adequate amount of pain and replacing it with an artificial prosthesis that will
serve as the new hip joint.5
An elderly person who has had a total hip replacement will have important rules to
follow when it comes to the positioning of their body. Depending on the particular approach
the orthopedic surgeon followed will depend on these specific positions. The most common
positions the patients will avoid are hip adduction, excessive extension, external rotation,
and internal rotation.2 The hip joint needs time to heal after the surgery; therefore, these
positions could easily dislocate the joint. The knowledge in physical therapy is continually
increasing, and continues to be a key factor after surgery because it decreases the length of
the hospital stay.4 During physical therapy, the therapist will teach the patient how to
properly use the assistive device that they were given following the surgery. The elderly
usually refrain from crutches because they do not have the strength to use them; therefore,
a walker or cane normally is given to help their mobility. These assistive devices allow
minimum stretching of the affected limb which is needed in the early stages of recovery.1
Once the physical therapist creates a plan of care for the patient they will gradually work
together to reach their goals. The main factors of the exercise program given to anyone who
had a total hip replacement are safe range-of-motion exercises and strengthening
exercises.3 In physical therapy, the therapist will evaluate the progression of not only the
new hip joint and how well the patient is recovering, but the therapist will also keep records
of the elder’s cardiovascular endurance too. This is very important to a physical therapist
because there are liability issues that can come into factor when dealing with patients. They
will continue to check their patients’ heart rate and blood pressure as they are doing the
exercise program provided by the therapist.3 Depending on the progress the patient is
making and their overall health, the full recovery can last anywhere from three to six
months.
A total hip replacement is one of the most successful operations in the orthopedic
setting. The increase in life expectancy is rising and this will increase the number of total
hip replacements performed. The surgery helps a lot of older people dealing with pain, and
is a lifesaver to the fallen elderly.
Works Cited
1. Woodford, H., & George, J. (2013). Acute medicine in the frail elderly. London: Radcliffe
Publishing.
2. Fagerson, T. L. (1998). The hip handbook. Boston: Butterworth-Heinemann.
3. Martin, R. L., & Kivlan, B. R. (2013). Classification-Based Treatment of Hip Pathology in
Older Adults. Topics In Geriatric Rehabilitation, 29(4), 218-226.
doi:10.1097/TGR.0b013e3182940bb4
4. Singh JA, Kundukulam JA, Kalore NV. Total hip replacement surgery versus conservative
care for hip osteoarthritis and other non-traumatic diseases (Protocol). Cochrane
Database of Systematic Reviews 2013, Issue 9. Art. No.: CD010731. DOI:
10.1002/14651858.CD010731
5. Maidment, Z. L., Hordacre, B. G., & Barr, C. J. (2014). Effect of weekend physiotherapy
provision on physiotherapy and hospital length of stay after total knee and total hip
replacement. Australian Health Review : A Publication of the Australian Hospital
Association, 38(3), 265-270. doi:10.1071/AH13232