Femoral Head Core Decompression Rehab Protocol

[Teje]

I have exhausted my internet options and have not been able to locate a physio protocol for post-op Femoral Head Core Decompression. I had the surgery 29 April and begin physio on 12 May. I have found many guidelines for THA, however due to the instability of the femur/hip from the decompression, am NWB for 6 weeks. Any suggestions?

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[morwenna]

Sorry, just came across this, and I expect you are under the instruction of your own physio now anyway. How's it going?

I chatted to one of our ortho surgeons about this surgery this week, and he was under the opinion that no particular "physio" was required.

Personally I would advise just range of motion exercises until you are able to weight-bear, and then stuff like cycling and graduated strength training after the 6 weeks are up.

I wouldn't suggest trying to run/jog etc, ie impact exercise, until well after the 12 weeks, and possibly never, given your condition, depending of the severity of the degeneration and how successful revascularization is. I haven't treated pataients with this, personally, but my understanding is that a fairly high proportion will go on to have arthroplasty. I suppose that these days a mid-head resection / resurfacing surgery would be indicated rather than a total hip replacement, if enough healthy bone remains........

Would be pleased to have news of your progress.

[Teje]

Hi Morwenna,

I didn't know anyone had replied to my thread re: core decompression-femoral head. I just wanted to thank you for your reply and let you know how I've been.

I work in a physio clinic as a PT aide, but I was the first "hip" my boss had, so we were both just reading and learning as we went. I was NWB for 8 weeks, PWB for the next 2 weeks, then crutches for any long distances (my walk to work is .8km) and a cane for general use up until about the 12th or 13th week. I did rehab as per a knee reconstruction - lots of SLR (all 4 planes) supine first, then standing. As I progressed, I moved to the stationary bike and standing SLR with theratubing. I maintained a very low impact level until the end of the 5th month and have slowly incorporated the treadmill and lots and lots of walking.

Fast forward to the 6th month. I had my follow-up with my surgeon Monday and the x-ray revealed almost no radiographic evidence of AVN. The hip looks almost normal. I was released to normal activity Monday and went out and played volleyball-woohoo!!!!! The hip feels good, very little to no pain, except at night.

I'll still have to monitor the hip every six months. I have an MRI at 9 months to check on the healing process, but for now, it looks good.

Thanks for replying.

Teje