Case Study Left Hip Total Replacement in 82-Year-Old Male

Assignment Task

Mr. ABC 78-year-old male patient who had a right total hip replacement surgery on steady step pathway. The patient presented with severe hip osteoarthritis that was causing significant pain and limiting mobility and quality of life (Evans et al., 2019). The past medical history includes hypertension, osteoarthritis, and gout. It is important to remember that reduced movement, mobility, and function will directly impact patient’s health. For example, risk of pressure injury, risk of deep vein thrombosis (DVT), social isolation, weight gain, constipation, and reduced income.

The rational for this case study was to provide a detailed examination of the postoperative assessment which include both restoration of function and biomechanical assessments of the patient’s gait following the total hip arthroplasty. According to the hip fracture clinical care standard data every year 19,000 people admitted in the hospital with a hip fracture and 1 in 4 people with a hip fracture die within a year (Australian Commission on Safety and Quality in Health Care [ACSQHC], 2023). The case study provides a detailed post procedure instruction which includes hourly neurovascular assessment, DVT prophylaxis, intravenous antibiotics, multimodal analgesia for pain management, and early mobilisation commence with physio.

The restoration of functional assessment measured range of motion with the help of physiotherapist. Restoration function can achieve through improving muscles strength and tone using strength assessment like manual muscle testing of hip, knee, and ankle musculature. The hip fracture clinical care standard guideline helps timely assessment by screening for malnutrition, frailty, cognitive impairment, risk factors for delirium, and follow orthogeriatric model of care for better patient outcome ( [ACSQHC], 2023). The biomechanical assessment used motion analysis to evaluate spatiotemporal gait parameters and dynamic range of motion. The biomechanical gait analysis was crucial in identifying the subtle gait abnormalities that could lead to long-term complication and lead to accelerated wear and failure of hip implant over time (Mierzejewska, 2015).

This case study provides valuable insights into the importance of comprehensive post-operative assessment which includes Mr. ABC mobility and activity: use of walkers or frame to prevent falls and protect the new hip, gradual progression on walking and activity, as tolerated, adherence to hip precautions to avoid dislocation for at least 6 weeks (example: no hip adduction, no bending past 90 degrees, no external or internal rotation) (Barnsley et al., 2015). The pain management: adequate pain relief medication which enable participation in rehabilitation, addressing patient concerns

about pain medication side effects or addiction (Pianka et al., 2021). Wound care: Monitoring the surgical incision for signs of infection, removal of stitches or staples around 12-day post-op, keeping the surgical incision site clean and dry (Tahririan et al.,2023). Thromboembolism prevention: use of TED stocking, foot compression pumps, and anticoagulant medications, monitoring for sighs of DVT or pulmonary embolism. Patient education and goal setting: encourage to establishing realistic expectation and goals with the physiotherapist, planning to minimize trips and falls during early recovery. Monitoring and follow-up: regular check-ups with the surgeon, including post-op x-ray to assess implant position, prompt reporting of any concerning symptoms like pain, swelling, or instability (Budzinska et al., 2022). A well informed and educated patient is more likely to participate pro-actively in their recovery.

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