After a patient has had surgery for a total hip replacement and, has had about 1 and a half weeks at a rehabilitation center, should the patient still recieve additional physical therapy on an out-patient basis? What are the general protocols for the next few months after a patient leaves the rehab center and is at home? The patient is an elderly woman about 76 years of age.

-- Cathleen Berardino (gaman6@aol.com), July 15, 2001

Answers

Generally the treatment protocol and rehabilitation protocol that I use for patients after a total hip replacement are six weeks with two crutches and 20% and then six weeks with one crutch or a cane and 50- 100% weight-bearing increasing weekly. After three months, the patient should be able to walk without a limp and should be using no external support. The physical therapy needs to be tailored to the needs of the patient. Most patients can do quite well with outpatient physical therapy for a period of six weeks after surgery. Some patients require inpatient and others require short-term nursing home treatment for other associated disabilities. Almost all patients will need either inpatient or outpatient physical therapy for approximately six weeks after total hip replacement.

-- Marc W. Hungerford, M.D. (mhunger@jhmi.edu), August 14, 2001.

Each patient should receive physical therapy based upon their ability to tolerate the regimen. Very aggressive therapy may result in training injury which will set back the progress which in turn reduces the quality of the patient's life and may produce intense pain in some cases depending on the injury sustainted. Very careful monitoring, especially of the aged, as to the limits of tolerance and capability to increase levels of intensity.

-- Patricia L. Niemiec, R.N. (plniemiec@aol.com), December 29, 2002.