THR, Trochanteric bursitis and abduction ex's!

[alophysio]

Hi,

Perhaps you can propose a little "study" to see what works for ABD - use the "protocol" exercises and compare to weightbearing functional exercise and see if outcome measures are changed. Shouldn't be hard if you see that many patients a day! Which BTW is a lot of hips and knees!

The other question i had was...What period of time are you seeing the lateral hip pain and how long is it lasting. Perhaps immediately post-op, the swelling causes some muscle dysfunction which results in temporary lateral hip pain?

[morwenna]

Hi,

Perhaps you can propose a little "study" to see what works for ABD - use the "protocol" exercises and compare to weightbearing functional exercise and see if outcome measures are changed. Shouldn't be hard if you see that many patients a day! Which BTW is a lot of hips and knees!

The other question i had was...What period of time are you seeing the lateral hip pain and how long is it lasting. Perhaps immediately post-op, the swelling causes some muscle dysfunction which results in temporary lateral hip pain?

Sorry about the delay in replying ... I did try once, but was having internet problems at the time!

I do indeed "see" vast numbers of arthroplasties on a weekly basis .... but I am growing frustrated with the fact that I am not allowed to "treat" them myself, but can send a referral to a PT clinic for them to have treatment. I am normally allowed to offer advice when I see them, but have to send them to others for ongoing work to be done!

I did decide to document patients with lat hip pain ... as soon as I decided that they seem to have dried up!!
but they did previously seem to be coming in at the 12 wk mark rather than earlier.



It suggests that it starts after the strengthening exercises (that we start them on at 6 wks), but does not yet prove any causality. Normally after 6 weeks we are advising them to start to discard the cane indoors, if they haven't already, and start to make the hip support muscles work when walking. Most will still need a cane outdoors at this time.

To resurrect the argument about FWB after non-cemented hips ...... all our surgeons now allow their patients to routinely WBAT from immediately post-op now, as research has shown there to be no long-term differences in function, but longer rehab in patients kept protected WB for 6 weeks.

This I gather is fairly recent in Canada (/North America?), though I was FWB with uncemented hips before I came here from the UK, so was surprised to find PT's still observing the protected WB thing here when I arrived in 2005!